骨水泥不同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响.docx

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1、骨水泥不同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响姜猛1王婷婷2,吕科R1 .西安国际医学中心医院脊柱外科陕西西安7100002 .陕西中医药大学附属医院骨科陕西咸阳712000第一作者：姜猛(1987年)，男,硕士,副主任医师，主要从事脊柱退变性疾病、脊柱创伤、脊柱肿瘤、脊柱感染等疾病的临床研窕。邮箱：。通讯作者：吕科(1981,12-),男，汉族，陕西咸阳人，医学硕士，副主任医师，主要从事脊柱、骨关节疾病的临床、教学及科研工作。非邮箱：课题名称：陕西中医药大学培养计划项目课题编号:(2017SZKY-018)【摘要】目的探讨脊柱骨质疏松骨折单侧经皮椎体成形术(PVP)术后X

2、线检查骨水泥分布状况及其预后方法回顾性分析2019年3月至2023年3月我院收治的脊柱骨质疏松骨折行单侧PVP手术的患者80例的临床资料，根据X线检行骨水泥分布分为两组，观察组(骨水泥分布互相连通的致密型)42例，对照组(骨水泥分布互相分离的弥散型38例。随访12个月，比较两组的手术时间、术中骨水泥注入量:、骨水泥渗漏率、术后再发骨折发生情况：测量患者手术前后的前缘、后缘椎体高度，计算前、后缘高度比，测量术前、术后3天局部后凸角(CObb角)情况。于术前、术后1d、术后3个月、12个月采用视觉疼痛评分(VAS)、Oswcstry功能障碍量表(ODI)评估两组患者的疼痛及生活质量。结果观察组的手

3、术时间为(36.65805)min,明显短于对照组的(4O.769.I6)min,差异有统计学意义(P0.05)；观察组的透视次数、住院时间、前后缘高度比、术前及术后3d的CObb角分别为(169O4.I8)次、(12.095.21)ds(74.335.I9)、(13.312.21)。、(10.332.I9),对照组为(I7.O3517)次、0.05)；观察组的骨水泥濯注量为(3.34IO9)m1,骨水况渗漏6例(14.29%),明显少于对照组的(4.881.15)m1和15例(29.47%),差异具有统计学意义(PVO.05):两组术后邻近再发骨折发生率分别为11.90%、13.16%,差异

4、无统计学意义(P0.05)：观察组的术前、术后Id、术后3个月、术后12个月VAS评分及OD1评分分别为【(8330.13)分、(2.35O.I6)分、(1.37O.I3)分、(0.930.03)分】、(57.578.16)分、(20.877.16)分、(12.474.16)分、(11.213.63)分】.对照组为【(8.56015)分、(2.760.27)分、(1.970.52)分、(O.95O.I5)分】、(59.767.27)分、(21.77722)分、(17.869.27)分、(16.978.5()分】，两组术后VAS评分及OD1评分较术前均降低，且观察组术后Id、3个月VAS评分低于

5、对照组，术后3个月、12个月OD1评分低于对照组，差异有统计学意义P0.05)结论滑水泥水泥分布形态是影响二一错格式的.字体：非加粗PVP手术疗效及预后她重要因素，祥柱性跟疏松将拆单蝌M术骨水泥分疝胃水泥分俏彳IiiWy的：字体：非力羸相连通的致密型相较于弥散型效果更优，有助于缩短手术时间,减少术后骨水泥渗漏率少，带格式的小体：非用相缓解术后疼痛，提高生活质量，从而促进预后恢纪。【关键词】脊柱骨质疏松骨折；单侧穿刺；经皮椎体成形术；疗效：骨水泥；骨密度X-rayexaminationofbonecementdistributionandprognosisafteruni1atera1PVTsu

6、rgeryforosteoporoticfractureofthespineJiangMeng1,WangTingting11vKe2*1 .DepartmentofSpineSurgery,Xi,anInternationa1Medica1CenterHospita1,Xi,an,shaanxiprovinceChina.7100002 .DepartmentofOrthopedics,Affi1iatedhospita1ofshaanxiuniversityofChinesemedicine,xianyang.shaanxiprovinceChina,712000(AbstractObje

7、ctiveToinvestigatethedistributionandprognosisofbonecementafteruni1atera1pcrcu1aneusvertebrop1asty(PVP)ibrspina1osteoporosisfracture.MethodsAretrospectiveana1ysiswasperformedonthec1inica1dataof80patientswithspina1osteoporosisfractureswhounderwentuni1atera1PVPsurgeryfromMarch2019toMarch2023.andthedist

8、ributionofbonecementwasdividedintotwogroupsaccordingtoX-rayexamination,42casesintheobservationgroup(densetypewithinterconnectedbonecementdistribution)and38casesinthecontro1group(diffusetypewithseparatebonecementdistribution).After12monthsoffo11ow-up,theoperationtime,intraoperativeamountofbonecementi

9、njection,bonecement1eakagerate,andpostoperativerecurrenceoffractureswerecomparedbetweenthetwogroups：theheightoftheanteriorandposterioredgesofthevertebra1bodybeforeandaftersurgerywasmeasured,theheightratioof(heanteriorandposterioredgeswasca1cu1ated,andIhc1oca1posteriorconvexang1e(Cobbang1e)wasmeasure

10、dbeforeandaftersurgery.Visua1painscore(VAS)andOSWeStrydysfunction(ODI)wereusedtoassesspainandqua1ityof1ifeinthetwogroupsat1dayaftersurgery.3monthsaftersurgery,and12monthsaftersurgery.Resu1tsTheoperationtimeoftheobservationgroupwas(36.658.05)min.andthatofthecontro1groupwas(4O.769.I6)min.andtheobserva

11、tiongroupwasshorterthanthecontro1group,withastatistica11ysignificantdifference(P0.05);theamountofbonecementperfusionintheobservationgroupwas(3.341.()9)m1,and1hebonecement1eakagewas6cases(14.29%),whichwassignificant1y1owerthanthatofthecontro1group(4.881.15)n1and15cases(29.47%),andthedifferencewasstat

12、istica11ysignificant(P0.05);theVASscoresandODIscoreso(8.330.13)points,(2.350.16)points,(1.370.13)points,(0.930.03)points.(57.578.16)points(20.877.16)points,(12.474.16)points,(11.213.63)pointswcrcrespective1yintheobservationgroup,thecontro1groupwas(8.560.15)points,(2.760.27)points,(1.970.52)points,(0

13、.950.15)points,(59.767.27)points,(21.777.22)points.(17.869.27)points,(16.978.50)points,thepostoperativeVASscoreandODiscoreofthetwogroupswere1owerthanthoseinthepreoperativegroup,andtheVASscoresofIdand3monthsaftersurgeryintheobservationgroupwere1owerthanthoseinthecontro1group,andtheODIscoresat3monthsa

14、nd12monthsafterSUrgCrywere1owerthanthoseinthecontro1group,withstatistica11ysignificantdifferences(P0.05).Conc1usionThere1ative1yconnecteddistributionofbonecementforuni1atera1PVPofspina1osteoporoticfracturecanshortentheoperationtime,reducethe1eakagerateofpostoperativecement,re1ievepostoperativepain,improvethequa1ityof1ife,andpromoteprognosisrecovery.KcywordsOsteoporosisfractureofthespine:un