[1]蔡 鑫,俞鹏飞,韩 松,等.两种骨水泥推注技术治疗椎体压缩性骨折的临床疗效[J].医学信息,2020,33(23):80-83.[doi:10.3969/j.issn.1006-1959.2020.23.023]
　CAI Xin,YU Peng-fei,HAN Song,et al.The Clinical Effect of Two Bone Cement Injection Techniques in the Treatment of Vertebral Compression Fractures[J].Medical Information,2020,33(23):80-83.[doi:10.3969/j.issn.1006-1959.2020.23.023]
点击复制

两种骨水泥推注技术治疗椎体压缩性骨折的临床疗效()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
33卷
期数:
2020年23期
页码:
80-83
栏目:
论著
出版日期:
2020-12-01

文章信息/Info

Title:
The Clinical Effect of Two Bone Cement Injection Techniques in the Treatment of Vertebral Compression Fractures
文章编号:
1006-1959（2020）23-0080-04
作者:
蔡 鑫; 俞鹏飞; 韩 松; 等
（1.南京中医药大学附属苏州市中医医院脊柱外科，江苏 南京 215009； 2.苏州大学附属第一医院脊柱外科，江苏 苏州 215006）
Author(s):
CAI Xin; YU Peng-fei; HAN Song; et al
(1.Department of Spine Surgery,Suzhou Traditional Chinese Medicine HospitalAffiliated to Nanjing University of Chinese Medicine,Nanjing 215009,Jiangsu,China; 2.Department of Spine Surgery,the First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)
关键词:
骨质疏松; 椎体压缩性骨折; 经皮椎体成形术; 经皮椎体后凸成形术; 骨水泥
Keywords:
Osteoporosis; Vertebral compression fracture; Percutaneous vertebroplasty;  Percutaneous kyphoplasty; Bone cement
分类号:
R687.3
DOI:
10.3969/j.issn.1006-1959.2020.23.023
文献标志码:
A
摘要:
目的 探讨两种骨水泥推注技术治疗骨质疏松性椎体压缩性骨折（OVCF）的临床疗效。方法 收集2014年1月~2017年1月我院接受手术治疗的OVCF患者107例作为研究对象，其中62例行经皮椎体成形术（PVP）作为PVP组，45例行经皮椎体后凸成形术（PKP）作为PKP组，比较两组手术时间、术中出血量、骨水泥注入总量、术后第3天、6个月及12个月VAS评分、并发症发生率、椎体前缘高度、Cobb角及Oswestry功能障碍指数（ODI）。结果 PVP组手术时间和术中出血量分别为（29.24±4.53）min、（14.25±4.49）ml，优于PKP组的（37.18±5.13）min、（19.16±5.60）ml，差异有统计学意义（P＜0.05）；两组骨水泥注入量比较，差异无统计学意义（P＞0.05）。PVP组和PKP组在术后各时间点VAS评分均低于术前（P＜0.05），但组间比较，差异无统计学意义（P＞0.05）。PVP组术前及术后椎体前缘高度比较，差异无统计学意义（P＞0.05），而PKP组术后各时间点椎体前缘高度高于术前和PVP组，差异有统计学意义（P＜0.05）。两组术后各时间点Cobb角均较术前减小，且PKP组小于PVP组，差异有统计学意义（P＜0.05）。两组术后各时间点ODI小于术前，且术后第3个月、第12个月ODI均小于术后第3天，差异有统计学意义（P＜0.05），但组间术后各时间点ODI比较，差异无统计学意义（P＞0.05）。PVP组骨水泥渗漏和椎体骨折发生率分别为25.81%、9.68%，与PKP组的17.78%、8.89%比较，差异无统计学意义（P＞0.05）。结论 PVP和PKP均能有效治疗OVCF，PKP能复位压缩椎体高度，帮助患者恢复脊柱生理曲线，但手术时间长、难度大，而PVP则能在更短的时间内完成骨水泥注射。因此，临床医生应结合患者具体情况并灵活选择最适的手术方式。
Abstract:
Objective To explore the clinical efficacy of two bone cement injection techniques in the treatment of osteoporotic vertebral compression fractures (OVCF).Methods A collection of 107 patients with OVCF who underwent surgical treatment in our hospital from January 2014 to January 2017 were collected as the research objects. Among them, 62 patients underwent percutaneous vertebroplasty (PVP) as the PVP group,45 cases underwent percutaneous kyphoplasty (PKP) as the PKP group,the operation time, intraoperative blood loss, total amount of bone cement injection, VAS scores at 3 days, 6 months and 12 months after surgery, complication rate, anterior vertebral height, Cobb angle, and Oswestry dysfunction were compared between the two groups Index (ODI).Results The operation time and peri-operative bleeding of PVP group (29.24±4.53)min,(14.25±4.49)ml was better than that of PKP group(37.18±5.13)min, (19.16±5.60)ml, with signifcant difference (P<0.05), but there was no significant difference between these two groups in the volume of bone cement (P>0.05). The VAS scores of the PVP group and the PKP group were lower at all time points after the operation than before the operation (P<0.05), but there was no statistically significant difference between the groups (P>0.05). There was no significant difference in the anterior vertebral height between preoperative and postoperative in PVP group (P>0.05), but the anterior vertebral height of PKP group was higher than that of preoperative and PvP groups at each time point after operation, and the difference was statistically significant (P <0.05), as shown in Table 4. Cobb angle of the two groups at each time point after operation was decreased, and PKP group was smaller than PVP group, the difference was statistically significant (P<0.05), as shown in Table 5. ODI at each time point after operation was lower than that before operation, and ODI at 3 months and 12 months after operation was less than that at 3 days after operation (P<0.05), but there was no significant difference in ODI at each time point between the two groups (P>0.05). The incidence of bone cement leakage and vertebral fractures in the PVP group were 25.81% and 9.68%, respectively. Compared with 17.78% and 8.89% in the PKP group, there was no significant difference (P>0.05).Conclusion Both PVP and PKP can effectively treat OVCF. PKP can reduce and compress the height of the vertebral body and help patients restore the physiological curve of the spine, but the operation time is long and difficult, while PVP can complete bone cement injection in a shorter time. Therefore, clinicians should flexibly choose the most suitable surgical method based on the specific conditions of the patient.

参考文献/References:

[1]范彦鑫,陆向东,赵轶波,等.椎体成形术治疗老年胸腰椎骨质疏松性骨折的研究进展[J].实用骨科杂志,2020,26(8):712-715. [2]Cheng X,Long HQ,Xu JH,et al.Comparison of unilateral versus bilateral percutaneous kyphoplasty for the treatment of patients with osteoporosis vertebral compression fracture (OVCF): a systematic review and meta-analysis[J].Eur Spine J, 2016,25(11):3439-3449. [3]Zhou T,Lin H,Wang H,et al.Comparative study on the biomechanics between improved PVP and traditional PKP in the treatment of vertebral peripheral wall damage-type OVCF[J].Exp Ther Med,2017,14(1):575-580. [4]Lee JK,Jeong HW,Joo IH,et al.Percutaneous balloonkyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures:a case-control study[J].Spine J,2018,18(6):962-969. [5]李浩鹏,臧全金,冯超帅.经皮椎体成形术治疗骨质疏松性椎体压缩骨折的问题及展望[J].西部医学,2018(8):1093-1095. [6]中华医学会骨质疏松和骨矿盐疾病分会.原发性骨质疏松症诊疗指南(2017)[J].中华骨质疏松和骨矿盐疾病杂志,2017(5):3963-3982. [7]Bach HG,Lim RD.Minimally invasive spine surgery for low back pain[J].Dis Mon,2005,51(1):34-57. [8]熊国相.经皮椎体后凸成形术中应用高/低黏度骨水泥治疗椎体骨质疏松性骨折[J].脊柱外科杂志,2019(1):28-32. [9]周英杰,赵鹏飞,郑怀亮,等.两种骨水泥应用于老年胸腰椎骨折椎体成形术的疗效观察[J].中国矫形外科杂志,2015,23(4):364-367. [10]Anselmetti GC,Marcia S,Saba L,et al.Percutaneous vertebroplasty:multi-centric results from EVEREST experience in large cohort ofpatients[J].Eur J Radiol,2012,81(12):4083-4086. [11]曹源,郭金超,马超,等.骨水泥椎体强化与保守治疗骨质疏松椎体压缩性骨折再骨折风险的Meta分析[J].中国脊柱脊髓杂志,2018,28(9):31-39. [12]Wang F,Wang LF,Miao DC,et al.Which one is more effective for the treatment of very severe osteoporotic vertebral compression fractures:PVP or PKP[J].J Pain Res,2018(11):2625-2631. [13]Papanastassiou ID,Phillips FM,vanMeirhaeghe J,et al.Comparingeffects of kyphoplasty,vertebroplasty,and non-surgical managementin a systematic review of randomized and non-randomized controlledstudies[J].Eur Spine J,2012,21(9):1826-1843. [14]Gill JB,Kuper M,Chin PC,et al.Comparing pain reduction following kyphoplasty and vertebroplasty for osteoporotic vertebral compression fractures[J].Chinese Journal of Osteoporosis,2009,10(4):583-590. [15]Yang HL,Liu T,Zhou J,et al.Kyphoplasty versus vertebroplasty for painful osteoporotic vertebral compression fractures-which one is better?A systematic review and meta-analysis[J].Int J Spine Surg,2013,7(1):45-57. [16]谭斌,刘雄文,刘刚,等.经皮椎体后凸与经皮椎体成形术修复骨质疏松椎体压缩性骨折:随机分组比较[J].中国组织工程研究,2016,20(4):539-543.

相似文献/References:

[1]王 忻,赵 毅,朱 悦,等.甲状旁腺激素应用于大鼠脊髓损伤后防治骨质疏松的效果分析[J].医学信息,2018,31(02):54.[doi:10.3969/j.issn.1006-1959.2018.02.019]
　WANG Xin,ZHAO Yi,ZHU Yue,et al.Effect of Parathyroid Hormone on Prevention and Treatment of Osteoporosis after Spinal Cord Injury in Rats[J].Medical Information,2018,31(23):54.[doi:10.3969/j.issn.1006-1959.2018.02.019]
[2]吴玲,李玉兰.个性化心理护理干预应用于骨质疏松的临床效果观察[J].医学信息,2018,31(01):158.[doi:10.3969/j.issn.1006-1959.2018.01.062]
　WU Ling,LI Yu-lan.The Clinical Effect of Personalized Psychological Nursing Intervention on Osteoporosis[J].Medical Information,2018,31(23):158.[doi:10.3969/j.issn.1006-1959.2018.01.062]
[3]刘小花.经皮穿刺椎体成形术治疗老年性骨质疏松性 椎体压缩骨折的疗效分析[J].医学信息,2018,31(05):186.[doi:10.3969/j.issn.1006-1959.2018.05.070]
　LIU Xiao-hua.The Effect of Percutaneous Vertebroplasty in the Treatment of Senile Osteoporotic Vertebral Compression Fracture[J].Medical Information,2018,31(23):186.[doi:10.3969/j.issn.1006-1959.2018.05.070]
[4]杨可佳,孙春华,洪全明,等.经皮椎体成形术治疗骨质疏松性压缩性椎体骨折的疗效观察[J].医学信息,2018,31(17):98.[doi:10.3969/j.issn.1006-1959.2018.17.030]
　YANG Ke-jia,SUN Chun-hua,HONG Quan-ming,et al.Therapeutic Effect of Percutaneous Vertebroplasty for treatment of Osteoporotic Vertebral Compression Fracture[J].Medical Information,2018,31(23):98.[doi:10.3969/j.issn.1006-1959.2018.17.030]
[5]蒋俊良.老年股骨转子间骨折的手术治疗方法[J].医学信息,2018,31(23):58.[doi:10.3969/j.issn.1006-1959.2018.23.017]
　JIANG Jun-liang.Research Progress of Intertrochanteric Fractures of Femurin the Elderly[J].Medical Information,2018,31(23):58.[doi:10.3969/j.issn.1006-1959.2018.23.017]
[6]罗巧彦,凌止发,严宗逊,等.中老年女性骨代谢指标与骨质疏松的相关性研究[J].医学信息,2019,32(17):68.[doi:10.3969/j.issn.1006-1959.2019.17.021]
　LUO Qiao-yan,LING Zhi-fa,YAN Zong-xun,et al.Correlation between Bone Metabolic Markers and Osteoporosis in Middle-aged and Elderly Women[J].Medical Information,2019,32(23):68.[doi:10.3969/j.issn.1006-1959.2019.17.021]
[7]熊义博,刘学员,邓泽熙,等.老年人骨质疏松与动脉硬化的关系[J].医学信息,2019,32(19):106.[doi:10.3969/j.issn.1006-1959.2019.19.033]
　XIONG Yi-bo,LIU Xue-yuan,DENG Ze-xi,et al.Relationship Between Osteoporosis and Arteriosclerosis in the Elderly[J].Medical Information,2019,32(23):106.[doi:10.3969/j.issn.1006-1959.2019.19.033]
[8]常 双,殷晓明,殷兰芳,等.FRAX联合血清学指标评估老年T2DM患者骨质疏松风险的研究[J].医学信息,2022,35(16):76.[doi:10.3969/j.issn.1006-1959.2022.16.017]
　CHANG Shuang,YIN Xiao-ming,YIN Lan-fang,et al.Evaluation of Osteoporosis Risk in Elderly Patients with T2DM by FRAX Combined with Serological Markers[J].Medical Information,2022,35(23):76.[doi:10.3969/j.issn.1006-1959.2022.16.017]
[9]李海龙,刘成升,刘艺明,等.PVP与PKP经单侧入路治疗骨质疏松性椎体压缩骨折的疗效比较[J].医学信息,2021,34(04):136.[doi:10.3969/j.issn.1006-1959.2021.04.036]
　LI Hai-long,LIU Cheng-sheng,LIU Yi-ming,et al.Comparison of the Curative Effect of PVP and PKP in the Treatment of Osteoporotic Vertebral Compression Fractures via Unilateral Approach[J].Medical Information,2021,34(23):136.[doi:10.3969/j.issn.1006-1959.2021.04.036]
[10]刘长志.经皮椎体成形术对骨质疏松性椎体压缩骨折患者VAS及ODI评分的影响[J].医学信息,2019,32(22):112.[doi:10.3969/j.issn.1006-1959.2019.22.036]
　LIU Chang-zhi.Effect of Percutaneous Vertebroplasty on VAS and ODI Scores in Patients with Osteoporotic Vertebral Compression Fractures[J].Medical Information,2019,32(23):112.[doi:10.3969/j.issn.1006-1959.2019.22.036]
[11]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.[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].Medical Information,2019,32(23):85.[doi:10.3969/j.issn.1006-1959.2019.11.023]
[12]庞 渊,张 庆,阿伍提·艾克木,等.经皮椎体成形术治疗骨质疏松性椎体压缩性骨折的 疗效分析[J].医学信息,2019,32(11):116.[doi:10.3969/j.issn.1006-1959.2019.11.033]
　PANG Yuan,ZHANG Qing,Awti Aikemu,et al.Therapeutic Effect of Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures[J].Medical Information,2019,32(23):116.[doi:10.3969/j.issn.1006-1959.2019.11.033]
[13]贯福春.X线、MRI诊断原发性骨质疏松椎体压缩性骨折的价值[J].医学信息,2020,33(03):171.[doi:10.3969/j.issn.1006-1959.2020.03.057]
　GUAN Fu-chun.The Value of X-ray and MRI in the Diagnosis of Primary Osteoporotic Compression Fracture of Vertebral Body[J].Medical Information,2020,33(23):171.[doi:10.3969/j.issn.1006-1959.2020.03.057]

更新日期/Last Update: 1900-01-01