【摘要】 背景:经皮椎体成形是治疗骨质疏松性椎体压缩性骨折的有效治疗方法之一,骨水泥在椎体内的分布形态会对其临床疗效产生影响。目的:探讨经皮椎体成形治疗中骨水泥分布形态对骨质疏松性椎体压缩性骨折术后早期疗效的影响。方法:选择2017年1月至2019年6月山西医科大学第一医院收治的骨质疏松性椎体压缩性骨折患者132例,其中男52例,女80例,年龄(76.3±8.2)岁,经皮椎体成形治疗后根据X射线片上的骨水泥分布形态分为弥散不良组(n=54)和弥散分布组(n=78)。对比两组术后目测类比评分、伤椎椎体前缘高度及中线高度、局部后凸Cobb角与术后随访1年并发症的发生率。研究的实施符合山西医科大学第一医院对研究的相关伦理要求。结果与结论:(1)两组术后2 d、1个月、6个月的目测类比评分均低于术前(P <0.05);弥散不良组术后1个月的目测类比评分高于弥散分布组(P <0.05),两组间术后2 d、6个月的评分比较差异无显著性意义(P> 0.05);(2)两组术后的局部后凸Cobb角、椎体前缘及中间高度均较术前改善(P <0.05),两组间术后局部后凸Cobb角、椎体前缘及中间高度比较差异均无显著性意义(P> 0.05);(3)两组间骨水泥渗漏率比较差异无显著性意义(P> 0.05),弥散分布组邻近椎体再发骨折发生率低于弥散不良组(P <0.05);(4)结果表明,经皮椎体成形是骨质疏松性椎体压缩性骨折的有效治疗方法,骨水泥在椎体内的分布会影响手术效果,骨水泥分布弥散可以减少伤椎邻近椎体再发骨折的发生率。更多还原

【Abstract】 BACKGROUND: Percutaneous vertebroplasty is one of the effective treatments for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will influence the clinical efficacy.OBJECTIVE: To investigate the influence of the distribution of bone cement in percutaneous vertebroplasty on the early postoperative outcomes after osteoporotic vertebral compression fractures.METHODS: A total of 132 patients, including 52 males and 80 females, with a mean age of(76.3±8.2) years who diagnosed as osteoporotic vertebral compression fractures in First Hospital of Shanxi Medical University from January 2017 to June 2019 were enrolled. All patients were divided into underdispersion group(n=54) and diffuse distribution group(n=78) according to the pattern of cement distribution on postoperative X-rays. Visual analogue scale scores postoperatively, the height of anterior edge and midline of injured vertebrae, Cobb angle of local kyphosis and the incidence of complications after 1-year follow-up were compared between the two groups. The trial was performed in accordance with the relevant ethical requirements for research in the First Hospital of Shanxi Medical University. RESULTS AND CONCLUSION:(1) The visual analogue scale scores were lower at 2 days, 1 and 6 months after operation than those before operation in the two groups(P < 0.05). The visual analogue scale scores at 1 month after operation in the underdispersion group were higher than those in the diffuse distribution group(P < 0.05), and there was no significant difference between the two groups at 2 days and 6 months after operation(P > 0.05).(2) Cobb angle and vertebral body height improved in both groups postoperatively compared to preoperatively(P < 0.05). The difference in Cobb angle and vertebral body height was not statistically significant between the two groups(P > 0.05).(3) The rate of bone cement infiltration was not significantly different between the two groups(P > 0.05). Incidence of recurrent fractures in adjacent vertebrae was lower in the diffuse distribution group than that in the underdispersion group(P < 0.05).(4) These findings confirm that percutaneous vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures. The distribution of bone cement in the vertebral body will affect the surgical results. The bone cement is diffusely distributed, which may reduce the incidence of recurrent fractures in adjacent vertebrae.更多还原