复合骨水泥椎体成形治疗骨量减少胸腰椎骨折
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赵加庆,滨州医学院在读硕士研究生,研究方向:脊柱外科,(电话)15677081550,(电子信箱)1627999428@qq.com

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R683.2

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山东省自然科学基金资助项目(编号:ZR2017LH020)


Percutaneous vertebroplasty with calcium phosphate composed bone cement for single-segment thoracolumbar fracture in osteopenia
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    摘要:

    [目的] 探讨磷酸钙复合骨水泥椎体成形术 (percutaneous vertebroplasty, PVP) 治疗骨量减少型胸腰椎骨折的疗效。 [方法] 回顾性分析本科 2018 年 1 月—2019 年 12 月收治的 69 例骨量减少型胸腰椎骨折患者的临床资料,依据医患沟通结果,32 例采用复合骨水泥 PVP,37 例采用保守治疗。比较两组临床与影像资料。[结果]PVP 组均顺利完成手术,术中发生 2 例椎间隙渗漏。69 例患者平均随访 (14.01±1.12) 个月,PVP 组恢复下地行走时间及完全负重时间均明显早于保守组 (P< 0.05)。随时间推移,两组治疗后 VAS 及 ODI 评分均显著降低 (P<0.05),JOA 评分均显著升高 (P<0.05)。治疗后 6 个月 PVP 组上述指标均优于保守组 (P<0.05),但末次随访时两组间 VAS、ODI 及 JOA 评分差异均已无统计学意义 (P>0.05)。影像方面,与治疗前相比,治疗 6 个月后及末次随访时 PVP 组伤椎前缘高度显著增加 (P<0.05),而局部 Cobb 角明显减小 (P< 0.05);相比之下,与治疗前相比,治疗 6 个月后和末次随访时保守组伤椎前缘高度显著降低(P<0.05),而局部 Cobb 角显著增大 (P<0.05)。而治疗后相应时间点,PVP 组上述影像指标均显著优于保守组 (P<0.05)。[结论] 对于骨量减少型胸腰椎骨折患者,磷酸钙复合骨水泥 PVP 是一种安全可靠的治疗方式,可迅速减轻骨折疼痛,恢复更快且无需长期卧床。

    Abstract:

    [Objective] To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) with calcium phosphate composed bone cement for single-segment thoracolumbral compression fracture in osteopenia. [Methods] A retrospective study was conducted on 69 patients who were hospitalized in our department for single-segment thoracolumbar fracture in osteopenic condition from January 2018 to December 2019. According to doctor-patient communication, 32 patients received composite bone cement PVP, while the other 37 patients received conservative treatment (the CT group) . The clinical and imaging data of the two groups were compared. [Results] All the patients in the PVP group had operation performed successfully despite of 2 cases of intervertebral leakage occurred during operation, whereas all those in the CT group had no adverse reaction during the therapy. All the 69 patients were followed up for (14.01±1.12) months on an aver- age. The PVP group resumed walking, and full weight-bearing activity significantly earlier than the CT group (P<0.05) . The VAS and ODI scores significantly decreased (P<0.05) , whereas JOA scores significantly increased over time in both groups (P<0.05) , which in PVP group proved significantly superior to the CT group at 6 months after treatment (P<0.05) , whereas became not statistically significant be- tween them at the last follow-up (P>0.05) . Radiographically, the PVP group got a significant increase of the anterior height of injured ver- tebrae, while a significant decrease of local kyphotic Cobb's angle at 6 months and at the latest follow-up compared with those before treat- ment (P<0.05) . However, the CT group got significantly reverse variations in the anterior vertebral body height and local kyphotic Cobb's angle anomg the time points compared with the PVP group (P<0.05) . At corresponding time points after treatment, the PVP group was sig- nificantly superior to the CT group in abovesaid image indexes (P<0.05) , regardless of the fact that no statistically significant differences in the radiographic parameters were noticed before treatment. [Conclusion] Calcium phosphate composed bone cement PVP is a safe and reliable treatment for single-segment thoracolumbar fracture in the osteopenic condition, which relieve pain quickly, recover function faster without long-term bed rest.

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赵加庆,赵子豪,于先凯,等. 复合骨水泥椎体成形治疗骨量减少胸腰椎骨折[J]. 中国矫形外科杂志, 2022, 30 (16): 1457-1461. DOI:10.3977/j. issn.1005-8478.2022.16.04.
ZHAO Jia- qing, ZHAO Zi- hao, YU Xian- kai, et al. Percutaneous vertebroplasty with calcium phosphate composed bone cement for single-segment thoracolumbar fracture in osteopenia[J]. Orthopedic Journal of China , 2022, 30 (16): 1457-1461. DOI:10.3977/j. issn.1005-8478.2022.16.04.

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  • 收稿日期:January 01,2022
  • 最后修改日期:June 15,2022
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  • 在线发布日期: June 29,2023
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