实用老年医学

实用老年医学 ›› 2024, Vol. 38 ›› Issue (4): 367-371.doi: 10.3969/j.issn.1003-9198.2024.04.010

• 临床研究 • 上一篇    下一篇

侧卧位对骨质疏松性椎体压缩性骨折病人单侧PKP骨水泥分布的影响

白云峰, 李明哲, 宋睿嘉, 袁若婷, 雷智轩, 史默涵, 曹书畅, 吴涛   

  1. 210003江苏省南京市,南京市第二医院骨科(白云峰);
    210011江苏省南京市,南京医科大学第二附属医院骨科(李明哲,史默涵,曹书畅,吴涛);
    211166江苏省南京市,南京医科大学第二临床医学院(宋睿嘉,袁若婷,雷智轩)
  • 收稿日期:2023-06-30 发布日期:2024-04-23
  • 通讯作者: 吴涛,Email:13770329486@163.com
  • 基金资助:
    江苏省自然科学基金面上项目(BK20181499)

Effects of lateral decubitus position on bone cement distribution in elderly patients with osteoporotic vertebral compression fracture undergoing unilateral percutaneous kyphoplasty

BAI Yunfeng, LI Mingzhe, SONG Ruijia, YUAN Ruoting, LEI Zhixuan, SHI Mohan, CAO Shuchang, WU Tao   

  1. Department of Orthopedics, the Second Hospital of Nanjing, Nanjing 210003, China(BAI Yunfeng);
    Department of Orthopedics, the Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, China (LI Mingzhe, SHI Mohan, CAO Shuchang, WU Tao);
    The Second School of Clinical Medicine, Nanjing Medical University, Nanjing 211166, China (SONG Ruijia, YUAN Ruoting, LEI Zhixuan)
  • Received:2023-06-30 Published:2024-04-23
  • Contact: WU Tao, Email: 13770329486@163.com

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摘要： 目的 研究侧卧位对骨质疏松性椎体压缩性骨折(OVCF)病人单侧经皮椎体球囊扩张后凸成形术(PKP)骨水泥分布的影响。 方法 对2018年1月至2022年1月在我院脊柱外科行单侧PKP治疗的OVCF病人进行回顾性分析。根据骨水泥注入过程中使用的体位将病人分为侧卧位组和俯卧位组,比较2组治疗及随访期间的影像学和症状指标。 结果 本研究共纳入190例病人,94例病人接受侧卧位水泥注射(侧卧位组),96例病人接受俯卧位水泥注射(俯卧位组)。2组病人术后症状和影像学指标均明显改善。与俯卧位组相比,术后1周,侧卧位组的VAS评分显著降低(P<0.05)。与俯卧位组相比,侧卧位组骨水泥分布分级更优(P<0.05),水泥渗漏率较低(13.8%比26.0%,P<0.05)。最后一次随访时,侧卧位组对侧椎体高度高于俯卧位组[(18.3±1.08)mm比(17.4±1.03)mm,P<0.05]。 结论 侧卧位可有效改善单侧PKP病人的骨水泥分布,更好地缓解急性疼痛,降低骨水泥渗漏发生率及远期对侧椎体高度塌陷程度。

关键词: 侧卧位, 经皮椎体球囊扩张后凸成形术, 水泥分布, 骨质疏松性椎体压缩性骨折

Abstract: Objective To study the effects of the lateral decubitus position on the bone cement distribution in the elderly patients with osteoporotic vertebral compression fracture (OVCF) undergoing unilateral percutaneous kyphoplasty (PKP). Methods A retrospective analysis was conducted in the patients who underwent unilateral PKP treatment for OVCF in the Department of Spine Surgery of our hospital from January 2018 to January 2022. All patients were divided into the lateral decubitus group and the prone position group according to the decubitus position during cement injection. The imaging information and symptom indexes of the two groups were compared during treatment and follow-up. Results A total of 190 patients were enrolled in this study. Ninety-four patients received cement injections in the lateral decubitus position, while 96 patients were in the prone position. Compared with the prone position group, visual analogue scoring of pain (VAS scores) one week after surgery was significantly lower, grading distribution of cement distribution was better and cement leakage rate was significantly lower in the lateral decubitus group (P<0.05). At the last follow-up, the contralateral vertebral height in the lateral position group was significantly higher than that in the prone position group [(18.3±1.08) mm vs (17.4±1.03) mm, P<0.05]. Conclusions The lateral decubitus position can efficiently improve the distribution of cement in the elderly patients undergoing unilateral PKP, relieve acute pain better, reduce the incidence of cement leakage and the extent of the contralateral vertebra collapse in the long term.

Key words: lateral decubitus position, percutaneous kyphoplasty, cement distribution, osteoporotic vertebral compression fracture

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