不同方式灌注骨水泥治疗骨质疏松性椎体压缩骨折的比较

发布时间：2018-03-18 22:52

本文选题：骨质疏松性骨折　切入点：骨折　出处：《中国组织工程研究》2017年14期 　论文类型：期刊论文

【摘要】：背景:骨水泥灌注治疗骨质疏松性椎体压缩骨折后,随着骨质疏松的进行和骨水泥与骨组织间隙的增大,骨水泥-骨界面的抗压缩和抗扭转能力下降,骨水泥块在椎体内的微运动幅度增加,易导致伤椎再骨折发生。目的:探讨3种方式灌注骨水泥治疗骨质疏松性椎体压缩骨折的临床疗效。方法:以单椎体骨质疏松性压缩骨折患者为研究对象,进行椎体成形术、椎体后凸成形术及椎体成形术分次灌注骨水泥治疗各60例,整理相关数据,分析椎体内骨水泥块的类别与治疗方式的关系,了解患者长期疼痛缓解及日常活动功能改善、椎体高度及骨水泥块形态位置改变、伤椎再骨折发生等情况。结果与结论:(1)3组治疗后的目测类比评分、Oswestry功能障碍指数和Cobb's角均较治疗前改善(P0.05);治疗后6个月与末次随访相比差异无显著性意义,各时间点组间相比差异无显著性意义,说明3种方法缓解疼痛和恢复行动的效果无差异,均能够防止椎体高度丢失,维护脊柱的力学性能;(2)骨水泥形态位置发生改变及伤椎再骨折均出现在团块型骨水泥病例中,为增加长期疗效,在灌注骨水泥时应尽可能在椎体内形成混合型或骨小梁型骨水泥。
[Abstract]:Background: with the development of osteoporosis and the increase of the gap between bone cement and bone tissue, the anti-compression and anti-torsion ability of bone cement-bone interface is decreased after the treatment of osteoporotic vertebral compression fracture with bone cement infusion. The micromotion of bone cement in the vertebral body increased, Objective: to investigate the clinical effect of three kinds of cement infusion in the treatment of osteoporotic vertebral compression fracture. Methods: vertebroplasty was performed in patients with osteoporotic compression fracture of single vertebral body. 60 cases of vertebral kyphoplasty and 60 cases of vertebroplasty were treated with bone cement respectively. The data were collected, and the relationship between the types of bone cement and the treatment methods was analyzed to understand the long-term pain relief and the improvement of daily activity function of the patients. Changes in the height of the vertebral body and the shape and location of the bone cement block, Results and conclusion Oswestry dysfunction index and Cobb's angle in the three groups after treatment were better than those before treatment, and there was no significant difference between the 6 months after treatment and the last follow-up. There was no significant difference between the three groups at different time points, which showed that there was no difference in the effect of the three methods in relieving pain and restoring action, and all of them could prevent the loss of vertebral height. Maintenance of the mechanical properties of the spine. (2) changes in the morphology and location of bone cement and refracture of injured vertebrae were found in mass cement cases, in order to increase long-term curative effect. Mixed or trabecular cement should be formed in the vertebral body as much as possible.
【作者单位】：莒县人民医院介入科;郓城县人民医院放射科;解放军济南军区总医院医学影像科;
【基金】：国家高技术研究发展计划(863计划)资助(2013AA032203)~~
【分类号】：R687.3

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