【摘要】 目的：探讨单侧穿刺经皮椎体成形术(PVP)中骨水泥偏向分布对骨质疏松性椎体压缩骨折(OVCF)患者疗效及预后的影响。方法：选取2020年11月—2023年11月在黔西南布依族苗族自治州人民医院就诊的127例OVCF患者，按照X线正位片上骨水泥弥散是否过椎体中线呈对称分布，将其分为观察组(过中线组，61例)、对照组(未过中线组，66例)。比较两组不同时间点的疼痛视觉模拟评分法(VAS)、Oswestry障碍指数评分(ODI)、椎体校正情况、不良事件发生情况。结果：术后1个月、3个月，两组VAS评分、ODI评分较术前下降，且观察组低于对照组，差异有统计学意义(P<0.05)。术后3个月，两组VAS评分、ODI评分较术后1个月降低，观察组低于对照组，差异有统计学意义(P<0.05)。术后1个月、3个月，两组椎体前缘高度比值较术前均增大、伤椎局部后Cobb角均缩小，且观察组椎体前缘高度比值大于对照组，伤椎局部后Cobb角小于对照组，差异有统计学意义(P<0.05)。术后3个月，两组椎体前缘高度比值较术后1个月均增大、伤椎局部后Cobb角均缩小，观察组优于对照组，差异有统计学意义(P<0.05)。术后3个月，相比于对照组，观察组骨水泥渗漏率及伤椎再塌陷发生率低，差异有统计学意义(P<0.05)；两组邻椎骨折发生率比较，差异无统计学意义(P>0.05)。结论：OVCF患者实施单侧PVP术后骨水泥的偏向分布会影响疗效，其中术后骨水泥过中线疗效优于骨水泥未过中线，减轻患者疼痛感明显，椎体校正情况更好，有效减少骨水泥渗漏率、伤椎再塌陷发生率。更多还原

【Abstract】 Objective:To investigate the effect of biased distribution of bone cement during unilateral percutaneous vertebroplasty (PVP) on the efficacy and prognosis of patients with osteoporotic vertebral compression fractures (OVCF).Method:A total of 127 patients with OVCF who were treated in the Qiannan Buyi and Miao Autonomous Prefecture People’s Hospital from November 2020 to November 2023 were selected and divided into observation group (over the center line group,61 cases) and control group (without over the center line group,66 cases) according to the symmetrical distribution of bone cement on the anterior-position X-ray film.Pain visual analogue scale (VAS),Oswestry disability index (ODI),vertebral correction at different time points and adverse events were compared between the two groups.Result:At 1 month and 3 months after operation,VAS scores and ODI scores of the two groups were decreased compared with those before operation,and the observation group was lower than the control group,the differences were statistically significant (P<0.05).At 3 months after surgery,VAS score and ODI score of two groups were lower than that of 1 month after surgery,and the observation group was lower than the control group,the differences were statistically significant (P<0.05).At 1 month and 3 months after surgery,the ratio of vertebral anterior margin height increased and the Cobb angle decreased after local injury in both groups compared those before surgery,and the ratio of vertebral anterior margin height in the observation group was greater than that in the control group,while the Cobb angle after local injury was smaller than that in the control group,the differences were statistically significant (P<0.05).At 3 months after surgery,the ratio of vertebral anterior margin height increased in both groups,and Cobb angle decreased in both groups after local injury compared with 1 month after surgery,and the observation group was better than the control group,the differences were statistically significant (P<0.05).At 3 months after surgery,the incidence of bone cement leakage and recollapse of injured vertebra in the observation group was lower than that in the control group,the differences were statistically significant (P<0.05).There was no significant difference in the incidence of adjacent vertebral fracture between the two groups (P>0.05).Conclusion:The biased distribution of bone cement after unilateral PVP surgery in OVCF patients can affect the therapeutic effect.Among them,the effect of bone cement passing through the midline after surgery is better than that of bone cement not passing through the midline,which significantly reduces patient pain,improves vertebral correction,and effectively reduces the rate of bone cement leakage and the incidence of recollapse of injured vertebrae.更多还原