摘要
目的比较椎体成形与弯角椎体成形治疗老年骨质疏松性椎体压缩骨折(OVCF)病人的疗效。方法选择2018~2019年我院收治的108例老年OVCF病人作为研究对象,采用随机数表法分为A组和B组,每组各54例。A组采用常规椎体成形骨水泥注射治疗,B组采用弯角椎体成形骨水泥注射治疗。比较2组骨水泥分布情况、渗漏率、再骨折发生率。2组病人术后均随访12个月,比较2组手术前后伤椎椎体前缘高度、Oswestry功能障碍指数及VAS评分。结果B组骨水泥分布理想率为88.89%,明显高于A组的37.04%,差异有统计学意义(P<0.01)。2组术后12个月伤椎椎体前缘高度较术前明显提高(P<0.01),Oswestry功能障碍指数较术前明显降低(P<0.01),但2组间伤椎椎体前缘高度、Oswestry功能障碍指数差异均无统计学意义(P>0.05)。2组术后1、3、6、12个月VAS评分均显著低于术前(P<0.05),但2组间术后1、3个月VAS评分差异无统计学意义(P>0.05),B组术后6、12个月VAS评分显著低于A组(P<0.05)。B组骨水泥渗漏率为12.96%,明显低于A组的29.63%,差异有统计学意义(P<0.05)。2组术后椎体再骨折率差异无统计学意义(P>0.05)。结论相较于椎体成形术,弯角椎体成形术治疗老年OVCF病人,其骨水泥分布均衡性更好,渗漏率更低,远期疼痛改善效果更明显。
Objective To compare the efficacy of vertebroplasty and curved vertebroplasty in the treatment of elderly patients with osteoporotic vertebral compression fractures(OVCF).Methods From January 2018 to December 2019,108 elderly patients with OVCF in our hospital were selected and divided into group A and group B by using random number table,with 54 cases in each group.Group A was treated with conventional vertebroplasty bone cement injection,and group B was treated with curved vertebroplasty bone cement injection treatment.The distribution of bone cement,leakage rate,and the incidence rate of re-fracture were compared between the two groups.All the patients were followed up for 12 months after operation.The anterior edge height of injured vertebral body,Oswestry dysfunction index,and the score of Visual Analogue Scale(VAS)in both groups were recorded and compared before and after operation.Results The ideal rate of bone cement distribution in group B was 88.89%,compeared with 37.04%in group A(P<0.01).Twelve months after operation,the anterior edge height of injured vertebral body in both groups was significantly higher than that before operation(P<0.01),and the Oswestry dysfunction index in both groups was significantly lower than that before operation(P<0.01),but there were no significant differences in the two indexes between group A and group B(P>0.05).The score of VAS 1 month,3 months,6 months and 12 months after operation in both groups was significantly lower than that before operation(P<0.05),but there was no significant difference in the score of VAS between the two groups 1 month and 3 months after operation(P>0.05).The score of VAS in group B was significantly lower than that in group A 6 months and 12 months after operation(P<0.05).The rate of bone cement leakage in group B was 12.96%,compared with 29.63%in group A(P<0.05).There was no significant difference in the rate of postoperative vertebral re-fracture between the two groups(P>0.05).Conclusions Compared with vertebroplasty,curved vertebroplasty in the treatment of elderly patients with OVCF has better bone cement distribution,lower leakage rate,and more obvious improvement in long-term pain.
作者
郭杰
于利锋
孙巍
王强
刘欣伟
王春生
GUO Jie;YU Li-feng;SUN Wei;WANG Qiang;LIU Xin-wei;WANG Chun-sheng(Department of Orthopedics, the Second Hospital of Zhangjiakou, Zhangjiakou 075000, China)
出处
《实用老年医学》
CAS
2021年第10期1031-1035,共5页
Practical Geriatrics
基金
张家口市科技计划财政资助项目(1911023D-3)。
关键词
椎体成形
弯角椎体成形
骨质疏松
椎体压缩骨折
骨水泥分布
老年人
vertebroplasty
curved vertebroplasty
osteoporosis
vertebral compression fracture
bone cement distribution
aged
