北京生物醫(yī)學(xué)工程

脊柱矢狀位參數(shù)在骨質(zhì)疏松性椎體壓縮骨折治療中的價值

Value of spinal sagittal parameters in the treatment of osteoporosis vertebral compression fractures

作者：韓曉斌王建光田明李玉民

單位：民航總醫(yī)院骨科(北京 100123)<br />通信作者:王建光。E-mail: wangjianguang04272@ 163. com

關(guān)鍵詞：骨質(zhì)疏松癥; 椎體壓縮骨折; 脊柱矢狀位參數(shù); Cobb角

分類號：R318.1

出版年·卷·期（頁碼）：2021·40·4（413-417）

摘要：

目的探討脊柱矢狀位參數(shù)在骨質(zhì)疏松性椎體壓縮骨折(osteoporoticvertebralcompressionfractures , 0VCF)治療中的價值。方法選取2016年1月至2019年9月民航總醫(yī)院骨科收治的84例骨質(zhì)疏松性椎體壓縮骨折患者進(jìn)行回顧性分析。將84例骨質(zhì)疏松性椎體壓縮骨折患者分為單次骨質(zhì)疏松性椎體壓縮骨折組和多次骨質(zhì)疏松性椎體壓縮骨折組，術(shù)前均行X線、MRI/骨掃描檢查，進(jìn)行視覺模擬評分( visual analogue scale, VAS)，并測量脊柱Cobb角以及C7鉛垂線與骨折椎體的距離( the distancebetween the C7 plumb line and the fracture vertebra, DSVA)。兩組患者均行經(jīng)皮穿刺椎體成形術(shù)治療。結(jié)果單次骨質(zhì)疏松性椎體壓縮骨折組術(shù)前和術(shù)后VAS比較.差異具有統(tǒng)計學(xué)意義(P<0.05)。多次骨質(zhì)疏松性椎體壓縮骨折組術(shù)前和術(shù)后VAS比較,差異具有統(tǒng)計學(xué)意義(P<0.05)。單次和多次骨質(zhì)疏松性椎體壓縮骨折組術(shù)前VAS比較,差異無統(tǒng)計學(xué)意義(P>0.05)。單次和多次骨質(zhì)疏松性椎體壓縮骨折組術(shù)后VAS比較，差異無統(tǒng)計學(xué)意義(P>0.05)。單次和多次骨質(zhì)疏松性椎體壓縮骨折組脊柱Cobb角比較，差異有統(tǒng)計學(xué)意義(P<0.05)。單次和多次骨質(zhì)疏松性椎體壓縮骨折組的DSVA比較,差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論脊柱矢狀位參數(shù)Cobb角和DSVA對骨質(zhì)疏松性椎體壓縮骨折臨床治療的生物力學(xué)穩(wěn)定性具有重要意義,可為取得最佳臨床效果提供重要的參考價值。

Objective To discuss the value of spinal sagittl parameters in the treatment of osteoporosisvertebral compression fractures. Methods Eighty-four patients with vertebral compression fractures admitted tothe department of orthopedics in Civil Aviation General Hospital from January 2016 to September 2019 wereselected for retrospective analysis. These cases of vertebral compression fractures were divided into two groupsincluding the one of single vertebral compression fractures and the other of multiple vertebral compression fractures. Preoperative X-ray and MRL/ radionuclide bonescan examinations were performed for visual analogue scale/ score( VAS) , through which both the Cobb angle of the spine and the distance between the C7 plumb line and the fracture vertebra ( DSVA ) were measured.Moreover , percutaneous vertebroplasty was carried out in both groups. Results Scores of VAS before and afterthe single vertebral compression fracture operations were compared, and the difference was statisticallysignificant ( P<0. 05). Similarly , the difference between scores of VAS before and after operations of multiplevertebral compression fractures were also statistically significant ( P<0.05 ). However , there was no statisticallysignificant difference between scores of VAS before single vertebral compression fracture operations and thosebefore operations of multiple vertebral compression fractures (P>0. 05). The same was true for the differencebetween scores of VAS after single vertebral compression fracture operations and those after operations ofmultiple vertebral compression fractures ( P> 0.05). Furthermore , there was statistically significant differencebetween Cobb angles of the spine with single vertebral compression fracture and that with multiple vertebralcompression fractures ( P< 0.05). The comparison of single vertebral compression fracture and multiplevertebral compression fractures by DSVA was statistically significant( P<0.05 ). Conclusions The sagittal spinalparameters Cobb angle and DSVA have great influence on the biomechanical stability of the clinical treatment ofosteoporotic vertebral compression fractures, which can be used as important references to achieve the bestclinical effects.

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