北京生物醫(yī)學(xué)工程

側(cè)推椎體內(nèi)注射聚甲基丙烯酸甲酯骨水泥治療骨質(zhì)疏松性椎體隱匿性骨折的應(yīng)用研究

Application of lateral injection of polymethyl methacrylate bone cement in the treatment of osteoporotic vertebral occult fracture

作者：王建光許有銀吳俊賢韓曉斌李玉民

單位：民航總醫(yī)院骨科（北京 100123） <p>通信作者：王建光。E-mail：[email protected]</p> <p> </p>

關(guān)鍵詞：骨質(zhì)疏松性椎體壓縮性骨折；椎體隱匿性骨折；骨水泥分布；經(jīng)皮椎體成形術(shù)；側(cè)推技術(shù)

分類號：R318.01 

出版年·卷·期（頁碼）：2022·41·3（271-274）

摘要：

目的探討側(cè)推椎體內(nèi)注射聚甲基丙烯酸甲酯骨水泥治療骨質(zhì)疏松性椎體隱匿性骨折的臨床治療效果。方法選擇民航總醫(yī)院2016年3月至2019年9月采用經(jīng)皮椎體成形術(shù)（percutaneous vertebroplasty, PVP）治療骨質(zhì)疏松性椎體隱匿性骨折患者68例，側(cè)推組40例，對照組28例，兩組患者在年齡、性別、病情分級上無統(tǒng)計學(xué)差異。通過對比兩組患者的骨水泥注入量以及骨水泥分布情況評價側(cè)推的臨床效果；采用術(shù)后隨訪的疼痛視覺模擬評分法（visual analogue,VAS）評價手術(shù)效果；測量對比Cobb角以及椎體前緣的椎體高度（vertebral height,VH）評價脊柱畸形的矯正效果。結(jié)果骨水泥注入量和分布側(cè)推組與對照組差異具有統(tǒng)計學(xué)意義（P＜0.001)。側(cè)推組術(shù)后3 d與對照組VAS比較，差異具有統(tǒng)計學(xué)意義（P＜0.001），側(cè)推組和對照組術(shù)前和術(shù)后6個月、術(shù)后12個月VAS比較，差異無統(tǒng)計學(xué)意義（P＞0.05）。VH側(cè)推組和對照組差異具有統(tǒng)計學(xué)意義（P＜0.001）。Cobb角術(shù)后12個月側(cè)推組和對照組差異具有統(tǒng)計學(xué)意義（P＜0.05）。結(jié)論側(cè)推PVP治療骨質(zhì)疏松性椎體隱匿性骨折，椎體骨水泥注入量大且骨水泥分布狀況良好，術(shù)后患者疼痛緩解顯著，椎體前緣高度恢復(fù)及Cobb角得到矯正，術(shù)后恢復(fù)快，可取得滿意的中遠(yuǎn)期療效，同時顯著預(yù)防椎體進一步塌陷及脊柱后凸畸形的發(fā)生。

Objective To investigate the clinical effect of lateral push vertebra injection of polymethyl methacrylate bone cement in the treatment of osteoporotic vertebral occult fracture. Methods 68 patients, 40 in the lateral push group and 28 in the control group, were selected from percutaneous vertebroplasty (PVP) for the treatment of osteoporotic occultation vertebral fractures in Civil Aviation General Hospital from March 2016 to September 2019. There was no statistical difference in age, gender and disease grade between the two groups. The clinical effect of lateral thrusting was evaluated by comparing the amount of bone cement injection and the distribution of bone cement between the two groups. Visual analogue scale (VAS) was used to evaluate the outcome of surgery. Cobb angle and vertebral height (VH) were measured to evaluate the effect of vertebral deformity. Results There was significant difference in the amount and distribution of bone cement injection between the lateral push group and the control group (P＜0.001). VAS of the lateral push group was significantly different from that of the control group 3 days after surgery (P <0.001), while VAS of the lateral push group was not significantly different from that of the control group before surgery, 6 months after surgery and 12 months after surgery (P＞0.05). There was significant difference in the front of VH between the thrust group and the control group (P＜0.001). The Cobb angle of the lateral thrust group and the control group was significant 12 months after operation (P＜0.05), while the other differences were not significant (P＞0.05). Conclusions PVP treatment of osteoporotic vertebral body thrust technology hidden fracture vertebral body bone cement injection quantity and distribution of bone cement is in good condition, postoperative pain relief in patients with significant, fanterior flange height recovery and Cobb angle correction, postoperative recovery fast, can obtain satisfactory long-term curative effect, at the same time significantly prevent further collapse and convex deformity after spinal vertebral bodies.

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