摘要
目的:探索椎体成形术(PVP)中“补丁技术”对于椎体前壁破裂的骨质疏松性压缩性骨折(OVCF)的应用方法和治疗效果。方法:选取拟行PVP手术治疗的椎体前壁破裂的OVCF病人72例,随机分为湿沙期骨水泥推注组(A组)、拉丝期骨水泥推注组(B组)、应用“补丁技术”组(面团早期骨水泥封闭椎体前壁破口,然后湿沙期骨水泥推注)(C组),各24例。术中均双侧穿入,推注速度基本相同,推注的骨水泥量均为4~5 mL。术后拍摄X线片,观察骨水泥的弥散情况和渗漏情况;3组病人术前、术后2 d进行ODI评分,评估疼痛缓解情况。结果:A组病人术后病椎骨水泥弥散状况佳,但发生C型渗漏高达13例(渗漏率54.17%);B组病人术后病椎骨水泥弥散状况欠佳,发生C型渗漏5例(渗漏率20.83%);C组病人术后病椎骨水泥弥散状况佳,且发生C型渗漏仅1例(渗漏率4.17%),3组渗漏率间差异有统计学意义(P<0.01)。3组病人术前ODI评分间差异无统计学意义(P>0.05);术后2 d,3组病人ODI评分均较术前明显降低(P<0.01),且A组和C组均明显低于B组,而A组与C组差异无统计学意义(P>0.05)。结论:PVP术中的“补丁技术”不仅有利于骨水泥在病椎内均匀分布,减少再骨折的发生,术后减轻疼痛效果好,且因其极低的渗漏率,手术安全性高。
Objective:To explore the application and therapeutic effect of"patch technique"in percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fracture(OVCF)with rupture of the anterior vertebral body.Methods:A total of 72 OVCF patients with rupture of the anterior vertebral body who underwent PVP were selected.All patients were randomly divided into three groups,24 cases in each group.Group A:bone cement injection during wet-sand phase,group B:bone cement injection during wire-drawing phase,group C:the"patch technique"was used to seal the fracture of the anterior vertebral body with bone cement in the early dough stage of paste,and then bone cement was injected in wet-sand phase.Both sides were penetrated during the operation,with basically same injection speed and 4-5 mL of bone cement volume for each side.Postoperative X-ray films were taken to observe the diffusion and leakage of bone cement.The pain relief of patients in the three groups was evaluated using the Oswestry disability index(ODI)before and 2 days post operation.Results:In group A,the cement in diseased vertebral body was relatively evenly distributed,while type-C leakage occurred in 13 cases(54.17%).In group B,the cement distribution in postoperative diseased vertebral body was relatively scattered,with 5 cases having type-C leakage(20.83%).In the group C,the cement in diseased vertebral body was relatively evenly distributed,there was only 1 case of type-C leakage(4.17%).There was significant difference in leakage rate among the three groups(P<0.01).There was no significant difference in preoperative ODI scores among the three groups(P>0.05).On the second day after operation,the ODI scores of the three groups were significantly lower than those before operation(P<0.01),and the ODI scores of group A and group C were significantly lower than those of group B,but there was no significant difference between group A and group C(P>0.05).Conclusions:The"patch technique"in PVP is beneficial for the even distribution of bone cement in the diseased vertebral body,reducing the occurrence of re-fracture,and alleviating postoperative pain.In addition,due to the lower leakage rate,this technique shows higher safety.
作者
许刚
张长春
朱坤
叶雨辰
赵想弟
姚文君
XU Gang;ZHANG Chang-chun;ZHU Kun;YE Yu-chen;ZHAO Xiang-di;YAO Wen-jun(Department of Spinal Surgery,The First Affiliated Hospital of Bengbu Medical College,Bengbu Anhui 233004;Bengbu Medical College,Bengbu Anhui 233030,China)
出处
《蚌埠医学院学报》
CAS
2022年第9期1159-1163,共5页
Journal of Bengbu Medical College
基金
安徽省高校自然科学研究重点项目(KJ2021A0743)。
关键词
椎体成形术
骨质疏松性压缩性骨折
椎体前壁破裂
补丁技术
骨水泥C型渗漏
percutaneous vertebroplasty
osteoporotic vertebral compression fracture
rupture of the anterior vertebral body
patch technique
type-C leakage of bone cement
