[1]张 强,杨 帆,陈 康,等.椎体成形术中明胶海绵填塞治疗椎体前壁破损的 OVCFs的临床疗效观察[J].医学信息,2019,32(11):85-89.[doi:10.3969/j.issn.1006-1959.2019.11.023]
　ZHANG Qiang,YANG Fan,CHEN Kang,et al.Clinical Observation of OVCFs in the Treatment of Anterior Wall Fracture of Vertebral Body with Gelatin Sponge During Vertebroplasty[J].Journal of Medical Information,2019,32(11):85-89.[doi:10.3969/j.issn.1006-1959.2019.11.023]
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椎体成形术中明胶海绵填塞治疗椎体前壁破损的 OVCFs的临床疗效观察()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
32卷
期数:
2019年11期
页码:
85-89
栏目:
论著
出版日期:
2019-06-01

文章信息/Info

Title:
Clinical Observation of OVCFs in the Treatment of Anterior Wall Fracture of Vertebral Body with Gelatin Sponge During Vertebroplasty
文章编号:
1006-1959（2019）11-0085-05
作者:
张 强1; 杨 帆1; 陈 康1; 李海波2; 范海泉1
1.核工业四一六医院脊柱骨科，四川 成都 610051； 2.成都双流区第一人民医院骨科，四川 成都 610051
Author(s):
ZHANG Qiang1; YANG Fan1; CHEN Kang1; LI Hai-bo2; FAN Hai-quan1
1.Department of Spinal Orthopaedics,Nuclear Industry 416 Hospital,Chengdu 610051,Sichuan, China; 2.Department of Orthopaedics,the First People's Hospital of Shuangliu District,Chengdu 610051, Sichuan,China
关键词:
明胶海绵填塞; 椎体压缩性骨折; 椎体成形; 骨质疏松
Keywords:
Key words：Gelatin sponge filling; Vertebral compression fracture; Vertebral body formation;  Osteoporosis
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2019.11.023
文献标志码:
A
摘要:
目的 分析椎体成形术（PVP）中明胶海绵填塞治疗椎体前壁破损的胸腰椎骨质疏松性骨折（OVCFs）的临床疗效。方法 通过回顾性分析我科2016年1月~2018年10月采用PVP手术治疗老年性OVCFs椎体前壁破裂80例，根据手术方法不同分为明胶绵组和对照组，各40例。明胶体海绵组PVP手术中对椎体前壁破损者联合明胶海绵填塞，对照组行常规PVP手术治疗椎体前壁破损患者。比较两组患者手术时间、单个椎体骨水泥注入量、椎体数、手术前后VAS 评分、ODI指数、椎体前缘高度、Cobb角以及骨水泥前方渗漏率。结果 80例患者均顺利完成手术。两组患者手术时间、单个椎体骨水泥注入量以及椎体数比较，差异无统计学意义（P＞0.05）；两组患者VAS评分、ODI指数、椎体前缘高度和Cobb角手术后比较，差异无统计学意义（P＞0.05）；明胶海绵组术后3 d VAS评分和ODI指数均低于术前[（2.68±1.34）分 vs （7.08±0.61）分，（20.91±6.09）vs（74.59±6.46）]，对照组术后3 d VAS评分和ODI指数均低于术前[（2.73±1.28）分 vs （6.81±0.87）分，（21.95±5.20）vs（75.96±5.12）]，差异有统计学意义（P＜0.05）。明胶海绵组术后椎体前缘高度大于术前[（22.09±2.41）mm vs （18.05±2.74）mm]，Cobb角小于术前[（11.01±2.42）° vs （20.80±5.23）°]，对照组术后椎体前缘高度大于术前[（21.81±2.31）mm vs （18.36±2.67）mm]，Cobb角小于术前[（12.74±3.06）° vs （22.41±4.48）°]，差异有统计学意义（P＜0.05）。明胶海绵组骨水泥前方渗漏率低于对照组（5.00% vs 25.00%），差异有统计学意义（P＜0.05）。结论 对于椎体前壁破裂者椎体成形术中是否使用明胶海绵填塞与其临床疗效无明显差异，但可有效降低椎体前方骨水泥的渗漏。
Abstract:
Abstract：Objective To analyze the clinical efficacy of gelatin sponge in the treatment of thoracolumbar osteoporotic fractures (OVCFs) in vertebral body anterior wall fracture in vertebroplasty (PVP). Methods Through retrospective analysis, 80 patients with anterior wall rupture of senile OVCFs were treated with PVP surgery from January 2016 to October 2018. According to different surgical methods, they were divided into gelatin cotton group and control group, 40 cases each. In the PVP operation of gelatin sponge group, the anterior wall of the vertebral body was damaged with gelatin sponge, and the control group was treated with conventional PVP for the treatment of anterior wall injury of the vertebral body. The operation time, single vertebral bone cement injection volume, vertebral body number, VAS score before and after surgery, ODI index, vertebral body leading edge height, Cobb angle and bone cement leakage rate were compared between the two groups.Results 80 patients successfully completed the operation. There was no significant difference in the operation time, single vertebral bone cement injection volume and vertebral body number between the two groups (P>0.05). The VAS score, ODI index, vertebral body height and Cobb angle were compared between the two groups,the difference was not statistically significant (P>0.05). The 3d VAS score and ODI index of the gelatin sponge group were lower than those before operation [(2.68±1.34) points vs (7.08±0.61) points, (20.91±6.09) vs (74.59±6.46)], and the control group 3 d VAS score and ODI index were lower than preoperative [(2.73±1.28) points vs (6.81±0.87) points, (21.95±5.20) vs (75.96±5.12)], the difference was statistically significant (P<0.05). The height of the anterior border of the vertebral body in the gelatin sponge group was greater than that before surgery [(22.09±2.41) mm vs (18.05±2.74) mm], and the Cobb angle was smaller than that before surgery [(11.01±2.42)° vs (20.80±5.23)°]. In the control group, the height of the anterior border of the vertebral body was greater than that before surgery [(21.81±2.31) mm vs (18.36±2.67) mm], and the Cobb angle was smaller than that before surgery [(12.74±3.06)° vs (22.41±4.48)°],the difference was statistically significant (P<0.05). The leakage rate of bone cement in the gelatin sponge group was lower than that in the control group (5.00% vs 25.00%),the difference was statistically significant (P<0.05).Conclusion There is no significant difference between the use of gelatin sponge in vertebroplasty for vertebral body anterior wall rupture and its clinical efficacy, but it can effectively reduce the leakage of bone cement in front of the vertebral body.

参考文献/References:

[1]陈艳玫,刘子锋,李贤德,等.2015-2050年中国人口老龄化趋势与老年人口预测[J].中国社会医学杂志,2018,35(5):480-483, [2]赵清华,孙旭,朱泽章,等.O-arm导航经皮椎体成形术治疗症状性椎体血管瘤[J].中国微创外科杂志,2016,16(10):917-921. [3]杨凡朋,张贤锋,徐应林,等.过伸体位复位经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折[J].临床骨科杂志,2018,21(4):419-421. [4]居正烨,陈圣宝,张长青.骨质疏松性椎体压缩性骨折研究进展[J].国际骨科学杂志,2018,39(1):33-36. [5]Chen C,Li D,Wang Z,et al.Safety and efficacy studies of vertebroplasty,kyphoplasty,and mesh-container-plasty for the treatment of vertebral compression fractures:preliminary report[J].PLoS One,2016,11(3):e0151492. [6]冯伟,勾瑞恩,曹珺,等.高黏度骨水泥PVP与低黏度骨水泥PKP治疗骨质疏松性椎体压缩骨折的比较[J].医药论坛杂志,2018,39(8):75-78. [7]陈智能,孙正友,叶俊才,等.明胶海绵的使用对椎体后凸成形术中骨水泥渗漏的影响[J].中国骨与关节损伤杂志,2015,30(11):1145-1148. [8]吴朗,黄成,冯新民,等.明胶海绵在经皮椎体成形术中预防骨水泥渗漏的作用研究[J].骨科,2018,8(3):179-183. [9]徐丽丽,王菲,陈文韬.止血粉和吸收性明胶海绵在肱骨骨折手术中止血效果的对比研究[J].临床和实验医学杂志,2018,18(17):1990-1902. [10]陈东,张文作,高朝友,等.双侧开窗减压加地塞米松明胶海绵治疗腰椎管狭窄症的疗效观察[J].医学信息,2014,27(11):352. [11]Meng B,Qian M,Xia SX,et al.Biomechanical characteristics of cement/gelatin mixture for prevention of cement leakage in vertebral augmentation[J].Eur Spine J,2013,22(10):2249-2255. [12]曾森炎,季卫锋,董玉鹏,等.高粘度与低粘度骨水泥PVP治疗骨质疏松性椎体压缩骨折的Meta分析[J].中国骨与关节损伤杂志,2018,33(3):240-243. [13]Wang CH,Ma JZ,Zhang CC,et al.Comparison of high-viscosity cement vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fractures[J].Pain Physician,2015,18(2):E187-E194. [14]Bastian JD,Keel MJ,Heini PF,et al.Complications related to cement leakage in sacroplasty[J].Acta Orthop Belg,2012,78(1):100-105.

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更新日期/Last Update: 2019-06-01