实用老年医学 ›› 2024, Vol. 38 ›› Issue (11): 1121-1125.doi: 10.3969/j.issn.1003-9198.2024.11.009

• 临床研究 • 上一篇    下一篇

骨水泥灌注率对骨质疏松椎体压缩性骨折病人经皮穿刺椎体成形术早期疗效及并发症的影响

牛茂林, 吴大鹏, 赵恩典, 孙浩远, 梁秋冬   

  1. 453000 河南省新乡市, 新乡医学院第一附属医院骨外科
  • 收稿日期:2023-12-05 出版日期:2024-11-20 发布日期:2024-11-21
  • 通讯作者: 梁秋冬,Email:13837385528@163.com
  • 基金资助:
    吴阶平医学基金会临床科研专项资助基金(320-2745-16-224)

Effect of bone cement perfusion rate on early efficacy and complications in elderly patients with osteoporotic vertebral compression fractures receiving percutaneous vertebroplasty

NIU Maolin, WU Dapeng, ZHAO Endian, SUN Haoyuan, LIANG Qiudong   

  1. Department of Orthopedics, the First Affiliated Hospital of Xinxiang Medical College, Xinxiang 453000, China
  • Received:2023-12-05 Online:2024-11-20 Published:2024-11-21
  • Contact: LIANG Qiudong, Email:13837385528@163.com

摘要: 目的 探究不同骨水泥灌注率对老年骨质疏松椎体压缩性骨折行经皮穿刺椎体成形术(PVP)病人早期临床疗效及并发症的影响。 方法 回顾性分析167例因骨质疏松椎体压缩性骨折行PVP手术的老年病人的临床资料,根据病人骨水泥灌注率将病人分为高灌注率组(20%≤骨水泥灌注率<30%,Ⅰ组,n=71)和低灌注率组(10%≤骨水泥灌注率<20%,Ⅱ组,n=96)。比较2组术前、术后VAS及Oswestry功能障碍指数(ODI)评分,骨水泥渗漏率、术后邻近椎体骨折率、术后伤椎再骨折率。 结果 2组病人术后VAS评分、ODI评分均较术前明显改善,差异具有统计学意义(P<0.01),但2组同期比较,差异无统计学意义(P>0.05)。Ⅰ组骨水泥渗漏率为42.25%,邻近椎体骨折率为18.31%,Ⅱ组骨水泥渗漏率为23.95%,邻近椎体骨折率为7.29%,差异均具有统计学意义(P<0.05)。Ⅰ组伤椎再骨折率为2.82%,Ⅱ组伤椎再骨折率为4.17%,2组差异无统计学意义(P>0.05)。 结论 骨水泥灌注率在10%~30%的范围内时,早期临床疗效无差异,但低骨水泥灌注率可以降低骨水泥渗漏及邻近椎体骨折的发生率。

关键词: 骨质疏松椎体压缩性骨折, 经皮穿刺椎体成形术, 骨水泥灌注率, 老年人

Abstract: Objective To explore the effects of different bone cement perfusion rates on the early clinical efficacy and complications in the elderly patients with osteoporotic vertebral compression fractures undergoing percutaneous vertebroplasty (PVP) surgery. Methods A retrospective analysis was conducted on the clinical data of 167 elderly patients who underwent PVP surgery for osteoporotic vertebral compression fractures. The patients were divided into the high perfusion rate group (20%≤bone cement perfusion rate<30%, Group Ⅰ, n=71) and the low perfusion rate group (10%≤bone cement perfusion rate<20%, Group Ⅱ, n=96). The preoperative and postoperative visual analogue scale (VAS) scores and Oswestry disability index (ODI) scores, as well as the rates of bone cement leakage, adjacent vertebral fractures, and postoperative re-fracture rate of injured vertebra in the two groups were recorded and compared. Results The postoperative VAS and ODI scores in both groups were significantly improved, with statistically significant differences (P<0.01). However, there was no statistically significant difference in VAS and ODI scores between the two groups (P>0.05). The leakage rate of bone cement in Group Ⅰ was 42.25%, the fracture rate of adjacent vertebral bodies was 18.31%, compared with 23.95% and 7.29% in Group Ⅱ with significant difference(P<0.05), respectively. The postoperative re-fracture rate of injured vertebra in Group Ⅰ was 2.82%, compared with 4.17% in Group Ⅱ with no significant difference (P>0.05). Conclusions Different bone cement perfusion rates within 10%-30% can bring the same early clinical efficacy, while low bone cement perfusion rate can reduce the risk of bone cement leakage and adjacent vertebral fractures.

Key words: osteoporotic vertebral compression fracture, percutaneous vertebroplasty, bone cement perfusion rate, aged

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