骨水泥不同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响.docx
骨水泥丕同分布形态对脊柱骨质疏松骨折单侧PVP手术效果及预后的影响姜猛L王婷婷，吕科"1.西安国际医学中心医院脊柱外科陕西西安7100002.陕西中医药大学附属医院骨科陕西咸阳712000第作者N姜猛(1987年)，男，硕士，副主任医师，主要从事脊柱退变性疾病、脊柱创伤、脊柱肿痛、脊柱感染等疾病的临床研完。邮箱：。通讯作者：吕科(1981,12-),男，汉族，陕西咸阳人，医学硕士，副主任医师，主要从事脊柱、骨关节疾病的临床、教学及科研工作。非邮箱：课题名称：陕西中医药大学培养计划项目课题编号：(2017SZKY-018)【摘要】目的探讨脊柱骨质疏松骨折单便!经皮椎体成形术(PVP)术后X线检查骨水泥分布状况及其预后,方法回顾性分析2019年3月至2022年3月我院收治的脊柱骨质疏松骨折行单侧PVP手术的患者80例的临床资料.根据X线检代骨水泥分布分为两组，观察组(骨水泥分布互相连通的致密型)42例，对照组(骨水泥分布互相分离的弥散型)38例。随访12个月，比较两组的手术时间、术中骨水泥注入量、骨水泥湾漏率、术后再发骨折发生情况：测量患者手术前后的前缘、后缘椎体高度，计算前、后缘高度比，测量术前、术后3天局部后凸角(CObb角)情况。于术前、术后Id、术后3个月、12个月采用视觉疼痛评分(VAS)、Oswcslry功能障碍量表(ODl)评估两组患者的疼痛及生活质量。结果观察组的手术时间为(3665±805)min,明显短于对照组的(40.76±9.16)min,差异有统计学意义(PVO.05):观察组的透视次数、住院时间、前后缘高度比、术前及术后3d的Cobb角分别为(16.90*4.18)次、(l2.09±5.21)d,(74.33±5.19).(I331±2.21)0.(IO33±2I9)°,对照组为(17.03士5.17)次、(13.l2±5.23)d(74.42士5.25)、(12.52士2.29)°、(9.42士2.15)°,两组相比差异无统计学意义(P005)；观察组的骨水泥灌注量为(3.34±L09)ml,骨水泥渗漏6例(14.29%),明显少于对照组的(4.88±1.15)Inl和15例(29.47%),差异具有统计学意义(PVO.05);两组术后邻近再发骨折发生率分别为11.90%、13.16%,差异无统计学意义(P>0.05):观察组的术前、术后Id、术后3个月、术后12个月VAS评分及ODl评分分别为(833±O.13)分、(235±0J6)分、(1.37±O.13)分、(0.93士0.03分】、(57.57+8.16)分、(20.87+7.16)分、(I2.47±4.16)分、(1121+3.63)分】,对照组为【(8.56÷0.15)分、(2.76+0.27)分、<1.97+0.52；分、(0.95÷0.15)分】、(59.76+7.27)分、(21.77±722)分、(17.86±9,27)分、(16.97±8.50)分】，两组术后VAS评分及ODl评分较术前均降低，且观察组术后Id、3个月VAS评分低于对照组，术后3个月、12个月（三）I'分低对照组，不坤仃统il学意义(P<0,05)结婚滑水泥水泥分布形态是影响钵式的：5体：MI粗PVP7厂；H2预后J为重要因素，臂S疏松骨折单侧PV”骨水讽分布丹水泥分伍：Ej1WMWH字体：非加粗相连通的致密型相较于弥散型效果更优，有助于缩短手术时间，减少术后骨水泥津漏率少，r*格大的：字体：非加粗缓解术后瘁痛，提高生活质量.从而促进预后恢旦。【关健词】脊柱骨质疏松骨折:单侧穿刺：经皮椎体成形术：疗效：骨水泥：骨变度X-rayexaminationofbonecementdistributionandprognosisafterunilateralPVPsurgcn'forosteoporoticfractureofthespineJiangMeng1,WangTingting1,LvKe"1.DepartmentofSpineSurgery,Xi,anInternationalMedicalCenterHospital,Xi,an,shaanxiprovinceChina7100002.DepartmentofOrthopedics,AffiliatedhospitalofshaanxiuniversityofChinesemedicine,XianyangtshaanxiprovinceChina712000AbstractObjectiveToinvestigatethedistributionandprognosisofbonecementafterunilateralPCrCUUinCOUSvertebroplasty(PVP)ibrspinalsteoprsislracturc.MethodsAretrospectiveanalysiswasperformedontheclinicaldataof80patientswithspinalosteoporosisfractureswhounderwentunilateralPVPsurgeryfromMarch2019toMarch2022,andthedistributionofboneccncnlwasdividedintotwogroupsaccordingtoX-rayexamination,42casesintheobservationgroup(densetypewithinterconnectedbonecementdistribution)and38casesinthecontrolgroup(diffusetypewithseparatebonecementdistribution).After12monthsoffollow-up.theoperationtime,inlrapcralivcamountofboneCCmCntinjection,bonecementleakagerate,andPOSk)PCraIiVCrecurrenceoffractureswerecomparedbetween(hetwogroups;theheightoftheanteriorandposterioredgesofthevertebralbodybeforeandaftersurgerywasmeasured,theheighlratioofIheanteriorandposterioredgeswascalculated,andthelocalposteriorconvexangle(Cobbangle)wasmeasuredbeforeandaftersurgery.Visualpainscore(VAS)andOswestrydysfunc(ion(ODl)wereusedtoas&esspainandqualiyoflifeinthetwogroupsa(1dayaftersurgery.3monthsaftersurgery,and12monthsaftersurgery.ResultsTheoperationtimeof(heobservationgroupwas(36.65+8.05)min.andthatofthecontrolgroupwas(40.76±9.16)min.andheobservationgroupwasshorterthanhecontrolgroup,withastatisticallysignificantdifference(P<0.05);thenumberoffluoroscopy,lengthofhospitalstay,anteriorandposteriormarginheightratio,andpreoperativeandpostoperative3dCobbangleswere(l6.90±4.18)times.(12.O9±5.2l)d,(74.33±5.19),(13.31±2.21)04(10.33±2.19)°,intheObsenationgroup,and(I7.O3±5.17)times,(13.12±5.23)d,(74.42±5.25),(12,52士2.29)°,(9.42÷2.15)°.therewasnosignificantdifferencebetweenthetwogroups(P>0.05Y.theamountofbonecementperfusioninLhCobservationgroupwas(3.34±1.()9)ml,andthebonecementleakagewas6cases(14.29%),whichwassignificantlylowerthanthatofthecontrolgroup(4.88±l.I5)mland15cases(29.47%).andthediffereewasstatisticallysignicant(P<0.05)Theincidenceofpostoperativerecurrenceofadjacentfracturesinthetwogroupswas11.90%and13.16%,respectively,withnosignificantdifference(P>0.05);theVASscoresandODlscoresof(8.33±0.13)points,(2.35±0.16)points,(1.37+0.13)points.(0.93+0.03)poin(s.(57.57±8.16)points(20.87±7.16)pints,(12.±47±4.16)points.(11.21±3.63)pointswcrcrcspcclivelyinLheobservationgroup,thecontrolgroupwas(8.56±O.I5)points,(2.76±0.27)points,(l.97±0.52)points,(0.95±0.15)poin(s,(59.76±7.27)poinls,(2l.77±7.22)oints.(17.86±9.27)points,(16.97±8.50)p<)ints,thepostoperativeVASscoreandODlscoreofthetwogroupswerelowerthanthoseinthepreoperativegroup,andtheVASscoresofIdand3monthsaftersurgeryintheobservationgroupwerelowerthanthoseinthecontrolgroup,andtheODlscoresal3monthsand12monthsaftersurgerywerelowerthanthoseinIhccontrolgroup,withSlatisticallySigniliCanldifferences(P<0.05).ConclusionTherelativelyconnecteddistributionofbonecementforunilateralPVPofspinalosteoporoticfracturecanshortentheoperationtime,reducetheleakagerateofpostoperativecement,relievepostoperativepain,improvethequalityoflife,andpromoteprognosisrecover）*.（Kcywordsjosceoporosisfractureof<hespine:uni
