| 王云清,李华,王斌,等.椎体成形术联合骨水泥明胶海绵复合体椎内填充治疗伴有上终板损伤的骨质疏松性椎体压缩骨折.骨科,2023,14(3): 260-264. |
| 椎体成形术联合骨水泥明胶海绵复合体椎内填充治疗伴有上终板损伤的骨质疏松性椎体压缩骨折 |
| Vertebroplasty Combined with Bone Cement Gelatin Sponge Complex Intravertebral Filling in the Treatment of Osteoporotic Vertebral Compression Fractures Patients with Upper Endplate Injury |
| 投稿时间：2022-09-02 |
| DOI：10.3969/j.issn.1674-8573.2023.03.012 |
| 中文关键词: 骨质疏松性骨折 脊柱骨折 上终板损伤 椎体成形术 骨水泥明胶海绵复合体 骨水泥渗漏 |
| 英文关键词: Osteoporotic fractures Spinal fractures Upper endplate injury Vertebroplasty PMMA-GS Bone cement leakage |
| 基金项目:江苏省老年健康科研项目（LK2021038）；徐州市科学技术局基金项目（KC21211） |
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| 中文摘要: |
| 目的 探讨经皮椎体成形术（PVP）联合骨水泥明胶海绵复合体（PMMA-GS）椎内填充治疗伴有上终板损伤的骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCF）病人的临床疗效。方法 回顾性分析2017年1月至2020年12月，采用PVP治疗伴有上终板损伤的OVCF病人77例，39例采用PVP联合PMMA-GS椎内填充治疗的病人纳入观察组，其中男16例，女23例，年龄为（73.6±2.3）岁；38例采用PVP治疗的病人纳入对照组，其中男17例，女21例，年龄为（74.2±2.3）岁。比较两组手术时间、骨水泥注入量、骨水泥渗漏率，以及两组术前、术后1年疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）、伤椎高度比。结果 两组均顺利完成手术，未出现肺栓塞、血气胸、肋骨骨折、脊髓神经、重要脏器损伤等并发症。两组病人的手术时间、骨水泥注入量比较，差异无统计学意义（P＞0.05）。观察组的骨水泥渗漏率（3/39，7.69%）明显低于对照组（11/38，28.95%），差异有统计学意义（χ2=5.845，P=0.019）。两组术后1年的VAS评分、ODI指数、伤椎高度比均较术前显著改善，差异有统计学意义（P＜0.05），但两组间比较，差异无统计学意义（P＞0.05）。结论 PVP联合PMMA-GS复合体椎内填充治疗伴有上终板损伤OVCF病人，相比PVP治疗术式能有效降低术中骨水泥椎间隙渗漏的发生。 |
| 英文摘要: |
| Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) combined with polymethyl methacrylate-gelatin sponge composite (PMMA-GS) in the treatment of osteoporotic vertebral compression fractures (OVCF) with upper endplate injury. Methods A retrospective analysis was conducted on 77 patients with OVCF and upper endplate injury who underwent PVP from January 2017 to December 2020. Among them, 39 patients were treated with PVP combined with PMMA-GS intraoperative filling (observation group), including 16 males and 23 females, with age of (73.6±2.3) years. The control group consisted of 38 patients who underwent PVP alone, including 17 males and 21 females, with age of (74.2±2.3) years. The surgical time, volume of bone cement injection, rate of bone cement leakage, as well as preoperative and 1-year postoperative visual analog scale (VAS), Oswestry Disability Index (ODI), and vertebral height ratio were compared between the two groups. Results Both groups completed the surgeries smoothly without complications such as pulmonary embolism, pneumothorax, rib fracture, spinal nerve, or important organ injury. There was no statistically significant difference in surgical time and volume of bone cement injection between the two groups (P＞0.05). The rate of bone cement leakage in the observation group (3/39, 7.69%) was significantly lower than that in the control group (11/38, 28.95%) with statistical significance (χ2=5.845, P=0.019). VAS scores, ODI, and vertebral height ratio were significantly improved postoperatively compared to preoperatively in both groups (P＜0.05), but there was no statistically significant difference between the two groups (P＞0.05). Conclusion PVP combined with PMMA-GS intraoperative filling in the treatment of OVCF with upper endplate injury can effectively reduce the occurrence of bone cement leakage during surgery compared to PVP alone. |
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