网袋加压椎体成形术治疗骨质疏松性椎体压缩性骨折

发布时间：2018-11-17 14:26

【摘要】：目的探讨网袋加压椎体成形术(vesselplasty)治疗骨质疏松性椎体压缩性骨折的临床效果。方法 2014年1月~2016年9月,对20例(22椎)胸腰椎压缩性骨折行网袋加压椎体成形术,平均骨密度T值-3.10(-4.44~-2.60),观察骨水泥渗漏,以及手术前后疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(Oswestry disability index,ODI)、椎体高度的变化。结果共9个椎体(40.9%)发生骨水泥渗漏,其中上下终板渗漏5例,椎管内2例,椎旁1例,肋椎旁1例。随访时间6~32个月,平均23个月。疼痛VAS和ODI术后第1天比术前均明显改善[术前vs.术后第1天:(7.2±0.8)分vs.(3.3±0.8)分,t=1.81,P=0.00;70.8%±7.5%vs.25.8%±7.5%,t=24.26,P=0.00],末次随访时继续改善[(1.9±0.9)分,t=7.88,P=0.00;16.0%±5.4%,t=6.18,P=0.00]。病变椎体前缘、中部、后缘高度术后第1天均明显增加[(16.4±6.0)mm vs.(19.1±6.5)mm,t=-4.88,P=0.00;(14.5±4.4)mm vs.(19.6±5.4)mm,t=-5.53,P=0.00;(23.9±5.3)mm vs.(27.4±5.8)mm,t=-5.33,P=0.00],末次随访时部分丢失[(18.2±6.4)mm,t=6.44,P=0.00;(18.2±5.0)mm,t=4.87,P=0.00;(26.2±5.4)mm,t=4.70,P=0.00]。Cobb角术后第1天明显减小(16.7°±7.4°vs.13.1°±5.5°,t=4.39,P=0.00),末次随访时部分丢失(16.2°±5.7°,t=-5.77,P=0.00)。结论网袋加压椎体成形术治疗骨质疏松性椎体压缩性骨折能显著缓解疼痛,有效恢复椎体高度。
[Abstract]:Objective to investigate the clinical effect of pouch compression vertebroplasty (vesselplasty) in the treatment of osteoporotic vertebral compression fracture. Methods from January 2014 to September 2016, 20 cases (22 vertebrae) of thoracolumbar vertebral compression fracture were treated with pouch compression vertebroplasty. The mean bone density (BMD) was -3.10 (-4.44 ~ 2.60), and the leakage of bone cement was observed. The changes of (visual analogue scale,VAS), Oswestry dysfunction index (Oswestry disability index,ODI) and vertebral height before and after operation. Results Bone cement leakage occurred in 9 vertebrae (40.9%), including 5 cases of upper and lower endplate leakage, 2 cases of vertebral canal, 1 case of paravertebral vertebra and 1 case of paraspinal rib. The follow-up time was 6 ~ 32 months (mean 23 months). Pain was significantly improved on the first day after VAS and ODI [vs. before operation] On the first day after operation: (7.2 卤0. 8) vs. (3.3 卤0. 8); 70.8% 卤7.5vs.25.8% 卤7.5t = 24.26P0.0.The last follow-up continued to improve [(1.9 卤0.9) points, t 7.88 P 0.000% 卤5.4t 6.18g P0. 00]. The height of the anterior, middle and posterior edge of the diseased vertebral body increased significantly on the first day after operation [(16.4 卤6.0) mm vs. (19.1 卤6.5) mm,t=-4.88,P=0.00;]. (14.5 卤4.4) mm vs. (19.6 卤5.4) mm,t=-5.53,P=0.00; (23.9 卤5.3) mm vs. (27.4 卤5.8 mm,t=-5.33,P=0.00) and partial loss at the last follow-up [(18.2 卤6.4) mm,t=6.44,P=0.00; (18.2 卤5.0) mm,t=4.87,P=0.00;] (26.2 卤5.4) mm,t=4.70,P=0.00]. On the first day after operation, the Cobb angle decreased significantly (16.7 掳卤7.4 掳vs.13.1 掳卤5.5 掳, t = 4.39 vs.13.1 卤5.00), and the partial loss was (16.2 掳卤5.7 掳, t ~ (-5.77) at the last follow-up. P0.00) Conclusion the treatment of osteoporotic vertebral compression fracture with pouch compression vertebroplasty can significantly relieve pain and recover vertebral body height.
【作者单位】：重庆医科大学附属第一医院骨科;
【基金】：国家自然科学基金(项目编号:81272171)
【分类号】：R687.3

【相似文献】