改良分次骨水泥推注在骨质疏松性腰椎压缩性骨折内固定术中的应用效果
Applied effect of modified graded bone cement injection in the internal fixation of the osteoporotic lumbar vertebral compression fractures
王进安 1李玉华 2刘文华3
作者信息
- 1. 潍坊医学院临床医学院,山东潍坊 261041
- 2. 潍坊医学院附属安丘市人民医院神经内科,山东潍坊 262114
- 3. 潍坊医学院附属医院脊柱外科,山东潍坊 261035
- 折叠
摘要
目的 探讨改良分次骨水泥推注在骨质疏松性腰椎压缩性骨折内固定术中的应用效果.方法 骨质疏松性腰椎压缩性骨折患者66例随机均分为对照组和研究组,两组均行经皮椎弓根螺钉内固定术及椎体成形术,其中对照组采取一次骨水泥注射椎体成形术、研究组采取改良分次骨水泥推注椎体成形术,术后均给与抗骨质疏松及抗感染等治疗,并随访6个月;记录两组患者手术耗时、骨水泥推注量及骨水泥渗漏发生情况,于术前、术后第3天及末次随访时视觉模拟评分法(VAS)评估疼痛程度,对比伤椎椎体前缘高度及后凸Cobb角,用Oswestry功能障碍指数(ODI)评估患者的脊柱功能障碍程度.结果 研究组患者手术耗时、骨水泥推注量与对照组比较,差异无统计学意义(P＞0.05);研究组骨水泥渗漏率低于对照组(P＜0.05);两组患者术后第3天、末次随访时的VAS评分、ODI评分均低于术前(P＜0.05),末次随访时VAS评分、ODI评分均较术后第3天降低(P＜0.05);两组患者术后第3天、末次随访时伤椎椎体前缘高度均高于术前(P＜0.05),后凸Cobb角均小于术前(P＜0.05);两组间不同时间点的VAS评分、ODI评分、伤椎椎体前缘高度及后凸Cobb角比较,差异无统计学意义(P＞0.05).结论 与传统一次骨水泥注射比较,改良分次骨水泥推注椎体成形术骨水泥渗透发生率较低.
Abstract
Objective To explore the applied effect of modified graded bone cement injection in the internal fixation of osteoporotic lumbar compression fractures.Method A total of 66 patients with osteoporotic lumbar compression fractures were randomly divided into the control group(32 cases)and the study group(34 cases).Both percutaneous pedicle screw fixation and vertebral body shaping were performed with the control group receiving traditional bone cement injection treatment and the study group receiving modified staged bone cement injection treatment.In addition to surgical treatment,both groups were given anti osteoporosis treatment.Antibiotics were given 24 hours after surgery to prevent infection,and the patients were encouraged to get out of bed early and exercise their limb functions(from mild to severe).The patients were also advised to gradually resume daily activities after discharge and to regularly visit the hospital for follow-up examinations;In addition,all the patients were followed up for 6 months after surgery.The postoperative surgical time,bone cement injection volume,and bone cement leakage values of the two groups were compared;Preoperative,postoperative 3D,and the final follow-up evaluations were conducted to compare the visual analogue scale(VAS)values of the two groups.The height of the anterior edge of the injured vertebral body and the Cobb angle of the posterior convexity before surgery were compared,,Evaluate the patient's preoperative,postoperative 3D,and the final follow-up Oswestry Disability Index(ODI)was used for intra and inter group comparisons.Results There was no statistically significant difference in surgical time and bone cement injection volume between the two groups(P＞0.05);The leakage rate of bone cement in the research group was lower than that in the control group(P＜0.05);The VAS scores and ODI scores 3 days after surgery and the last follow-up were lower than those before surgery(P＜0.05),and the scores at the last follow-up were lower than those at 3 days after surgery(P＜0.05);The height of the anterior edge of the injured vertebral body was higher than before surgery(P＜0.05)and the Cobb angle of the posterior convexity was lower than before surgery(P＜0.05)in both groups 3 days after surgery and at the last time of follow-up;There was no statistically significant difference(P＞0.05)in VAS scores,ODI scores,anterior vertebral height,and posterior Cobb angle of the two groups at different time points.Conclusion The application of modified graded bone cement injection in the internal fixation of osteoporotic lumbar compression fractures has a significant effect.
关键词
改良分次骨水泥推注/骨质疏松症/腰椎压缩性骨折/内固定术/经皮椎体成形术/骨水泥渗漏/肢体功能Key words
modified graded bone cement injection/osteoporosis/lumbar vertebral compression fractures/internal fixation/percutaneous vertebroplasty/leakage of bone cement/limb function引用本文复制引用
基金项目
山东省专业学位研究生教学案例库项目(SDYAL17060)
出版年
2024
NETL
NSTL
万方数据