摘要
目的探讨分析发生骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)后不同时期行新型骨囊袋填充椎体成型术(Vesselplasty)干预,在临床症状、影像学和术后并发症等方面的区别。方法对自2018年1月至2020年1月在首都医科大学附属北京友谊医院采用Vesselplasty治疗的125例OVCF患者的临床资料进行回顾性分析,根据手术时机分为两组:早期手术组(4周内手术)72例,共115个椎体;延迟手术组(4周后手术)53例,共73个椎体。比较所有患者手术前、术后1 d和术后1年的VAS评分、ODI评分、伤椎前缘高度比、脊柱后凸角(LKA)和手术并发症等情况。结果两组患者术后1 d和术后1年的VAS、ODI和LKA与术前相比均明显减小(P<0.05),两组间同随访时期的VAS、ODI评分无明显差别(P>0.05),但A组的LKA明显小于B组(P<0.05)。两组中所有患者术后1 d与1年的椎体前缘高度与术前相比均明显恢复(P<0.05),但同随访时期A组的椎体前缘高度比明显大于B组(P<0.05),且在术后1年时B组伤椎高度丢失明显大于A组(P<0.05)。两组间的骨水泥渗漏率无明显差别(P>0.05),术后1年相邻椎体继发骨折患者例数与再手术率B组高于A组(P<0.05)。结论对OVCF早期与延迟行Vesselplasty干预在改善VAS、ODI和在骨水泥渗漏方面无明显差别,但早期Vesselplasty治疗可更好地恢复椎体高度,减轻术后椎体再塌陷和减少相邻椎体继发骨折。
Objective To analyze the differences of vesselplasty in clinical symptoms,imaging features,and postoperative complications after osteoporotic vertebral compression fractures(OVCF)in different periods.Methods Clinical data of 125 patients with OVCF who received vesselplasty treatment in our hospital from January 2018 to January 2020 were retrospectively analyzed.According to the period of surgical treatment,they were divided into two groups:the early surgery group(Group A,surgery within 4 weeks),with 72 patients,including 115 vertebral bodies,and the delayed operation group(Group B,operation after 4 weeks),with 53 patients,including 73 vertebral bodies.Visual analogue score(VAS),Oswestry disability index(ODI),the anterior vertebral height compression rate,local kyphosis angle(LKA),and surgical complications were evaluated before surgery,1 day after surgery,and 1 year after surgery for all patients in the two groups.Results VAS,ODI score,and LKA of patients in the two groups were significantly reduced 1 day after surgery and 1 year after surgery compared with those before surgery(P<0.05).There was no significant difference in the VAS and ODI scores between the two groups during the same follow-up period(P>0.05).LKA in group A was significantly lower than that in group B during the same follow-up period(P<0.05).The anterior vertebral height of all patients was significantly obvious recovery compared 1 day after surgery and 1 year after surgery with preoperative state(P>0.05).However,during the same follow-up period,the anterior vertebral height compression rate in group A was significantly higher than that in group B,and the difference was statistically significant(P<0.05).Moreover,the height loss of injured vertebrae in group B was significantly greater than that in group A at 1 year after operation(P<0.05).There was no significant difference in bone cement leakage between the two groups(P>0.05).The number of patients with fractures of adjacent vertebral bodies and the reoperation rate in group B were significantly higher than those in group A at 1 year postoperatively(P<0.05).Conclusion Early or delayed vesselplasty for OVCF does not differ significantly in the reduction of VAS score,ODI,and bone cement leakage.However,early vesselplasty treatment for OVCF has advantages in restoring the height of the vertebral body,reducing postoperative vertebral recollapse,and reducing the incidence of secondary fractures in adjacent vertebral bodies.
作者
王开玉
包利
陈浩
贾璞
冯飞
孙海波
张双江
唐海
WANG Kaiyu;BAO Li;CHEN Hao;JIA Pu;FENG Fei;SUN Haibo;ZHANG Shuangjiang;TANG Hai(Orthopedic Center,Beijing Friendship Hospital Affiliated to Capital Medical University,Beijing 100050,China)
出处
《中国骨质疏松杂志》
CAS
CSCD
北大核心
2022年第8期1175-1179,1185,共6页
Chinese Journal of Osteoporosis
