PKP治疗不同骨密度T值骨质疏松症患者的临床疗效及预后
Clinical Efficacy and Prognoses of Percutaneous Kyphoplasty in the Treatment of Osteoporosis Patients with Different Bone Mineral Density T Values
陈锋 1许勇 1贺弘 1李永霞 1景青玲1
作者信息
- 1. 810000 西宁,青海大学附属医院脊柱外科
- 折叠
摘要
目的 探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗不同骨密度 T 值(bone mineral density T val-ue,BMD-T)骨质疏松症患者的临床疗效及预后,确认 BMD-T 在骨质疏松性骨折(osteoporotic fracture,OSF)手术中潜在的指导作用.方法 回顾性分析 2021 年 3～12 月在青海大学附属医院脊柱外科接受 PKP 治疗的 162 例 OSF 患者的临床资料,根据BMD-T不同将患者分为轻度组(-4≤BMD-T≤-2.5,n =40)、中度组(-5≤BMD-T<-4,n =78)和重度组(BMD-T<-5,n =44).比较手术前后椎体楔形角、后凸角度、椎体高度变化,并进行 Oswestry残疾指数(Oswestry disability index,ODI)、视觉模拟评分(visual analogue scale,VAS)和Barthel指数(Barthel index,BI)评分.随访 6 个月后,计算再骨折的发生率.结果 3 组患者的手术时间、术中出血、VAS评分、ODI评分、BI评分比较,差异无统计学意义(P>0.05);但重度组患者的骨水泥注入量高于其他两组,手术前后椎体楔形角、后凸角、椎体高度比较,差异有统计学意义(P<0.05).随访发现,3 组患者的再骨折率比较,差异无统计学意义(P>0.05).年龄、骨水泥渗漏、BMD-T是影响 OSF患者 PKP术后再骨折的独立因素(P<0.05).结论 PKP治疗不同 BMD-T骨质疏松症患者可达到理想的临床效果.BMD-T 越低,术后椎体高度和脊柱后凸的矫正越明显,但越容易发生骨水泥渗漏.
Abstract
Objective To investigate the clinical efficacy and prognosis of percutaneous kyphoplasty(PKP)in patients with osteo-porosisi with different bone mineral density T value(BMD-T)after,and confirm the potential guiding role of BMD-T in the surgical treatment of osteoporotic fracture(OSF).Methods The clinical date of 162 OSF patients who received PKP treatment in the Department of Orthopedics,Qinghai University Affiliated Hospital from March and December 2021 were retrospectively analyzed.They were divided into mild group(-4≤BMD-T≤-2.5,n =40),moderate group(-5≤BMD-T<-4,n =78)and severe group(BMD-T<-5,n =44)based on their BMD-T.The changes of vertebral wedge angle,kyphosis angle,vertebral height before and after surgery were compared,and the Oswestry disability index(ODI),visual analogue scale(VAS)and Barthel index(BI)scores were evaluated.After 6months of follow-up,the incidence of refracture was calculated.Results There were no significant differences in the operation time,intraoperative hemorrhage,VAS,ODI score and BI score among the three groups(P>0.05),but the amount of bone cement injected in the severe group was higher than that in the other two groups,and the differences were statistically significant in the vertebral wedge angle,kyphosis angle and vertebral height before and after surgery(P<0.05).The follow-up investigation identified there was no significant difference in the refracture rate among the three groups(P>0.05).And age,bone cement leakage,BMD-T were the independent fac-tors affecting refracture after PKP in OSF patients(P<0.05).Conclusion PKP can achieve ideal clinical effect in the treatment of os-teoporosis patients with different BMD-T.The lower the BMD-T,the more obvious the correction of vertebral height and kyphosis after operation,but the more prone to bone cement leakage.
关键词
骨质疏松性骨折/经皮椎体后凸成形术/骨密度T值Key words
Osteoporotic fracture/Percutaneous kyphoplasty/Bone mineral density T value引用本文复制引用
基金项目
青海省科技计划基础研究计划(2022-ZJ-777)
出版年
2024
NETL
NSTL
万方数据