临床外科杂志 ›› 2024, Vol. 32 ›› Issue (7): 736-739.doi: 10.3969/j.issn.1005-6483.2024.07.018

• 论著 • 上一篇    下一篇

经皮弯角椎体成形术治疗老年骨质疏松性椎体压缩骨折疗效分析

缪逸鸣 罗斌 陆苇 郑治 王强   

  1. 215500 江苏省常熟市中医院(常熟市新区医院)南京中医药大学常熟附属医院骨科
  • 收稿日期:2023-08-07 出版日期:2024-07-20 发布日期:2024-07-20
  • 通讯作者: 王强，Email:jktd20230605@163.com
  • 基金资助:
    江苏省常熟市卫生健康委员会科技计划项目(csws201928)；江苏省常熟市中医院医院青年科研基金项目(cszyy201914)；江苏省苏州市临床重点病种诊疗技术专项项目(LCZX201923)

Study on the effect of percutaneous angular vertebroplasty on functional recovery in elderly patients with osteoporosis vertebral compression fractures

MIAO Yiming,LUO Bin,LU Wei,ZHENG Zhi,WANG Qiang   

  1. Department of Orthopaedics，Changshu Municipal Hospital of Traditional Chinese Medicine (Changshu New District Hospital),Changshu Affiliated Hospital of Nanjing University of Traditional Chinese Medicine,Changshu,Jiangsu 215500,China
  • Received:2023-08-07 Online:2024-07-20 Published:2024-07-20

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摘要： 目的 探讨经皮弯角椎体成形术(PVCP)治疗老年骨质疏松性椎体压缩骨折(OVCF)病人的疗效。方法 2020年8月～2022年12月收治的OVCF病人108例。根据手术方式分为两组，对照组52例，采用经皮椎体成形术，观察组56例，采用PVCP；对比两组手术相关情况、术中透视次数、椎体功能恢复情况、影像学相关参数、功能障碍和腰部功能、步态、并发症情况。结果 观察组术中出血量少于对照组[(10.65±3.52)ml vs.(13.11±3.66)ml,P＜0.05],术中透视次数少于对照组[(14.21±4.27)次 vs.(17.04±4.25)次，P＜0.05],临床总有效率(89.28%)与对照组临床(86.53%)比较，差异无统计学意义(P>0.05)；术后2个月后影像学相关参数、功能障碍和腰部功能、手术和步态相关情况优于对照组(P<0.05)；两组切口感染、神经根损伤、再次骨折发生率比较，差异无统计学意义(P>0.05)，但观察组骨水泥渗漏率低于对照组(P＜0.05)。结论 两种手术均能有效改善OVCF病人的腰椎体功能水平，PVCP在增大椎体前后缘和中部高度、减小Cobb角更具有优势，术中透视次数和出血量相对更少，骨水泥渗漏发生率较低，更具有安全性。

关键词: 骨质疏松, 椎体压缩骨折, 经皮弯角椎体成形术, 功能恢复

Abstract: Objective Exploring the effect of Percutaneous angular vertebroplasty (PCVP) on functional recovery in elderly patients with osteoporotic vertebral compression fractures (OVCF).Methods Retrospective selection of clinical data from 108 OVCF patients admitted to our hospital from August 2020 to December 2022.According to the different surgical methods,52 cases were divided into a control group (percutaneous vertebroplasty) and an observation group (percutaneous vertebroplasty) with 56 cases;Compare the recovery of vertebral body function,imaging related parameters,functional impairment and lumbar function,surgical related conditions,gait,and complications between the two groups.Results The intraoperative blood loss in the observation group was less than that in the control group[(10.65±3.52)ml vs.(13.11±3.66)ml,P＜0.05],the number of intraoperative fluoroscopy was less than that of control group[(14.21±4.27) vs.(17.04±4.25)，P＜0.05],there was no statistically significant difference in the total clinical effective rate between the observation group of 89.28% and the control group of 86.53% (P>0.05).After 2 months of surgery,the imaging related parameters,functional impairment,lumbar function,surgical and gait related conditions in the control group were better than those in the control group (P<0.05).There was no statistically significant difference in the incidence of incision infection,nerve root injury,and recurrent fractures between the two groups (P>0.05),but the leakage rate of bone cement in the observation group was lower than that in the control group (P<0.05).Conclusion Both surgeries can effectively improve the level of lumbar vertebral function in OVCF patients.PVCP has advantages in increasing the height of the anterior and posterior edges of the vertebral body,reducing the Cobb angle,and relatively fewer intraoperative fluoroscopy times and bleeding.The incidence of bone cement leakage is lower,making it more safe.

Key words: osteoporosis, vertebral compression fracture, percutaneous angular vertebroplasty, functional recovery

[1] 杜龙宇 薛航 曹发奇 周武 米博斌 刘梦非 胡益强 刘国辉. 老年骨质疏松性胸腰椎压缩性骨折的诊疗进展[J]. 临床外科杂志, 2024, 32(4): 438-441.
[2] 中国老年学和老年医学学会老年病学分会骨科专家委员会 中华医学会骨科学分会青年骨质疏松学组 中国医师协会骨科医师分会骨质疏松学组 上海中西医结合学会骨质疏松专业委员会. 骨质疏松性椎体压缩骨折骨修复策略专家共识（2024版）[J]. 临床外科杂志, 2024, 32(4): 442-448.
[3] 陈礼 李雪光 张栋 曹传军. 象限法评估椎体成形术后骨水泥分布类型与骨质疏松性椎体新发骨折的关系[J]. 临床外科杂志, 2024, 32(2): 206-209.
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[13] 彭雄 陈嘉联. 骨质疏松压缩性骨折病人T11-L2椎体成形术后相邻椎体和终板应力的变化特征[J]. 临床外科杂志, 2020, 28(4): 377-379.
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