浸骨水泥明胶海绵预填注对胸腰椎OVCF患者PKP手术治疗后骨水泥渗漏的影响
Effect of bone cement gelatin sponge pre-filling on cement leakage of thoracolumbar OVCF patients after PKP surgery
陈龙飞1
作者信息
- 1. 开封市中心医院,河南 开封 475000
- 折叠
摘要
目的 探究浸骨水泥明胶海绵预填注对胸腰椎椎体压缩性骨折(OVCF)患者椎体后凸成形术(PKP)治疗后骨水泥渗漏的影响.方法 选取在我院接受PKP手术治疗的胸腰椎OVCF患者 101 例,采用信封法分为两组,对照组 50 例,观察组 51 例.两组患者均选择骨水泥分次注入方案,对照组采用明胶海绵填塞,观察组采用浸骨水泥明胶海绵预填注.对两组患者进行一年随访,记录两组患者的临床指标情况、明胶海绵及骨水泥使用情况、术前术后椎体后凸角及伤椎前缘高度、术后残余痛、术前术后Oswestry功能障碍指数(ODI)、骨水泥渗漏情况.结果 两组手术时间、住院时间比较,P>0.05.观察组明胶海绵用量、骨水泥注入量、总骨水泥用量均少于对照组(P<0.05).术前、术后组间椎体后凸角及伤椎前缘高度情况比较,P>0.05;术后两组患者的椎体后凸角均较术前减小,伤椎前缘高度较术前升高(P<0.05).两组术后 1 d、3 d、1 周时的疼痛缓解率组间比较,P>0.05.术前、术后 1 个月、3 个月、6个月两组间的腰椎功能ODI指数比较,P>0.05;但与术前比较,术后1 个月、3 个月、6 个月的腰椎功能ODI指数均降低(P<0.05).观察组术后渗漏总发生率低于对照组(P<0.05);组间邻近椎体骨折发生率比较,P>0.05.结论 在胸腰椎OVCF患者PKP手术治疗中采用浸骨水泥明胶海绵预填注可以降低骨水泥渗漏的发生率.
Abstract
Objective To explore the effect of bone cement gelatin sponge prefilling on cement leakage of thoracolumbar vertebral compression fracture(OVCF)patients after percutaneous kyphoplasty(PKP)treatment.Methods 101 patients with thoracolumbar OVCF after PKP treatment were selected as the study subjects and were randomly divided into the control group(n=50)and the observation group(n=51).The gelatin sponge was used in the control group,and the bone cement gelatin sponge were used in the study group.After 1 year's follow-up,the clinical indexes,the use of gelatin sponge and bone cement,kyphotic angle of vertebra and anterior height of injured vertebra before and after surgery,postoperative residual pain,Oswestry dysfunction index(ODI)before and after surgery and the leakage of bone cement were recorded.Results There was no significant difference in operation time and hospitalization time(P>0.05).The gelatin sponge dosage,bone cement injection and total cement dosage in the observation group were less than those in the control group(P<0.05).There was no significant difference in kyphotic angle of vertebra and anterior height of injured vertebra between the two groups before and after surgery(P>0.05),but after surgery the kyphotic angle of vertebra of the two groups decreased and the anterior height of injured vertebra of the two groups increased(P<0.05).There was no significant difference in postoperative residual pain between the two groups at 1 d,3 d and one week after surgery(P>0.05).There was no significant difference in lumbar ODI index between the two groups before surgery and 1 month,3 months and 6 months after surgery(P>0.05).Compared with that before surgery,lumbar ODI index 1 month,3 months and 6 months after surgery decreased(P<0.05).The leakage rate of bone cement in the observation group was lower than that in the control group(P<0.05).There was no significant difference in incidence of adjacent vertebral fractures between the two groups(P>0.05).Conclusion In the surgical treatment of PKP in patients with thoracolumbar OVCF,prefilling with bone cement gelatin sponge can reduce the occurrence of bone cement leakage.
关键词
椎体后凸成形术/骨质疏松性骨折/明胶海绵/骨水泥渗漏/残余痛Key words
Kyphoplasty/Osteoporotic fracture/Gelatin sponge/Cement leakage/Residual pain引用本文复制引用
出版年
2024
NETL
NSTL
万方数据