经皮椎体成形术后骨水泥弥散形式与临床疗效的关系
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摘要
目的:研究归纳骨水泥在经皮椎体成形术(PVP)后的弥散分布,分析不同类型弥散方式对治疗椎体压缩骨折患者的影响。方法:回顾性分析我院2015年1月至2017年6月诊治的椎体压缩性骨折患者74例,均应用骨水泥PVP行单侧穿刺后,根据影像学检查骨水泥弥散情况分成abc三组,统计并比较不同弥散情况术后的改善情况。结果:所有患者术后的VAS评分、ODI、脊柱生活量表、伤椎椎体前缘高度均较术前有显著改善(P<0.05);并且分析发现上下终板均弥散组患者的VAS评分、ODI、脊柱生活量表均较单终板弥散的类型有所提高(P<0.05),伤椎椎体前缘高度比较差异无统计学意义(P>0.05)。结论:椎体压缩性骨折经过PVP行单侧穿刺后并且使骨水泥分布到上下终板的弥散形式对患者的疗效优于上下终板未能同时弥散的情况。
Objective:To investigate the dispersion type of bone cement after percutaneous vertebroplasty(PVP)and its effect on patients with vertebral compression fractures. Methods:A total of 74 cases of patients with vertebral compression fractures treated by PVP in our hospital from Jan 2015 to Jun 2017 were retrospectively analyzed. After unilateral puncture with bone cement in PVP,all patients were divided into three groups(group A,B and C)according to the imaging dispersion,and the postoperative improvement of different dispersion conditions was statistically analyzed and compared. SPSS 19.0 software was used for statistical analysis. Results:The postoperative VAS score,ODI,spinal life scale and the height of the anterior margin of the injured vertebra were significantly improved in all patients(P < 0.05). The results showed that VAS score,ODI and spinal life scale of both upper and lower endplates were significantly higher than those of the single endplate(P < 0.05). There was no significant difference in the height of the anterior margin of the injured vertebra(P > 0.05). Conclusion:After PVP for vertebral compression fractures,the bone cement distributed to the upper and lower endplates has a better effect on patients than the bone cement distributed to the single endplate.
Objective:To investigate the dispersion type of bone cement after percutaneous vertebroplasty(PVP)and its effect on patients with vertebral compression fractures. Methods:A total of 74 cases of patients with vertebral compression fractures treated by PVP in our hospital from Jan 2015 to Jun 2017 were retrospectively analyzed. After unilateral puncture with bone cement in PVP,all patients were divided into three groups(group A,B and C)according to the imaging dispersion,and the postoperative improvement of different dispersion conditions was statistically analyzed and compared. SPSS 19.0 software was used for statistical analysis. Results:The postoperative VAS score,ODI,spinal life scale and the height of the anterior margin of the injured vertebra were significantly improved in all patients(P < 0.05). The results showed that VAS score,ODI and spinal life scale of both upper and lower endplates were significantly higher than those of the single endplate(P < 0.05). There was no significant difference in the height of the anterior margin of the injured vertebra(P > 0.05). Conclusion:After PVP for vertebral compression fractures,the bone cement distributed to the upper and lower endplates has a better effect on patients than the bone cement distributed to the single endplate.
引文
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[8]唐冲,吴四军,刘正,等.高黏度骨水泥在单侧经皮椎体成形术中的弥散分布特点[J].实用骨科杂志,2017,23(10):884-887
[9]Sun K,Liu Y,Peng H,et al.A comparative study of high-viscosity cement percutaneous vertebroplasty vs.low-viscosity cement percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures[J].J Huazhong Univ Sci Technolog Med Sci,2016,36(3):389-394.
[10]赵永生,李强,历强,等.骨水泥弥散类型对治疗骨质疏松性椎体压缩骨折的影响[J].中国骨伤,2017,30(5):446-4522018-03-10
[2]Tanigawa N,Komemushi A,Kariya S,et al.Radiological follow-up of new compression fractures following percutaneous vertebroplasty[J].Cardiovasc Intervent Radiol,2006,29(1):92-96.
[3]Filippiadis DK,Marcia S,Masala S,et al.Percutaneous vertebroplasty and kyphoplasty:Current status,new developments and old controversies[J].Cardiovasc Intervent Radiol,2017,40(12):1815-1823.
[4]Fairbank JC.The Oswestry disability index[J].J Neurosurg Spine,2014,20(2):239-241.
[5]徐宏光,贾瑞平,王弘,等.脊椎退行性疾病患者生命质量量表的编制[J].中华骨与关节外科,2011,4(6):441-449.
[6]Hiwatashi A,Moritani T,Numaguchi Y,et al.Increase in vertebral body height after vertebroplasty[J].AJNR Am J Neuroradiol,2003,24(2):185-189.
[7]吴强,莫世赞,包拥政,等.椎体成形治疗后骨水泥在椎体内弥散的影响因素[J].中国组织工程研究,2014,18(43):6922-6928.
[8]唐冲,吴四军,刘正,等.高黏度骨水泥在单侧经皮椎体成形术中的弥散分布特点[J].实用骨科杂志,2017,23(10):884-887
[9]Sun K,Liu Y,Peng H,et al.A comparative study of high-viscosity cement percutaneous vertebroplasty vs.low-viscosity cement percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures[J].J Huazhong Univ Sci Technolog Med Sci,2016,36(3):389-394.
[10]赵永生,李强,历强,等.骨水泥弥散类型对治疗骨质疏松性椎体压缩骨折的影响[J].中国骨伤,2017,30(5):446-4522018-03-10