【摘要】：目的探討網(wǎng)袋加壓椎體成形術(shù)(vesselplasty)治療骨質(zhì)疏松性椎體壓縮性骨折的臨床效果。方法 2014年1月~2016年9月,對(duì)20例(22椎)胸腰椎壓縮性骨折行網(wǎng)袋加壓椎體成形術(shù),平均骨密度T值-3.10(-4.44~-2.60),觀察骨水泥滲漏,以及手術(shù)前后疼痛視覺模擬評(píng)分(visual analogue scale,VAS)、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)、椎體高度的變化。結(jié)果共9個(gè)椎體(40.9%)發(fā)生骨水泥滲漏,其中上下終板滲漏5例,椎管內(nèi)2例,椎旁1例,肋椎旁1例。隨訪時(shí)間6~32個(gè)月,平均23個(gè)月。疼痛VAS和ODI術(shù)后第1天比術(shù)前均明顯改善[術(shù)前vs.術(shù)后第1天:(7.2±0.8)分vs.(3.3±0.8)分,t=1.81,P=0.00;70.8%±7.5%vs.25.8%±7.5%,t=24.26,P=0.00],末次隨訪時(shí)繼續(xù)改善[(1.9±0.9)分,t=7.88,P=0.00;16.0%±5.4%,t=6.18,P=0.00]。病變椎體前緣、中部、后緣高度術(shù)后第1天均明顯增加[(16.4±6.0)mm vs.(19.1±6.5)mm,t=-4.88,P=0.00;(14.5±4.4)mm vs.(19.6±5.4)mm,t=-5.53,P=0.00;(23.9±5.3)mm vs.(27.4±5.8)mm,t=-5.33,P=0.00],末次隨訪時(shí)部分丟失[(18.2±6.4)mm,t=6.44,P=0.00;(18.2±5.0)mm,t=4.87,P=0.00;(26.2±5.4)mm,t=4.70,P=0.00]。Cobb角術(shù)后第1天明顯減小(16.7°±7.4°vs.13.1°±5.5°,t=4.39,P=0.00),末次隨訪時(shí)部分丟失(16.2°±5.7°,t=-5.77,P=0.00)。結(jié)論網(wǎng)袋加壓椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮性骨折能顯著緩解疼痛,有效恢復(fù)椎體高度。
[Abstract]:Objective to investigate the clinical effect of pouch compression vertebroplasty (vesselplasty) in the treatment of osteoporotic vertebral compression fracture. Methods from January 2014 to September 2016, 20 cases (22 vertebrae) of thoracolumbar vertebral compression fracture were treated with pouch compression vertebroplasty. The mean bone density (BMD) was -3.10 (-4.44 ~ 2.60), and the leakage of bone cement was observed. The changes of (visual analogue scale,VAS), Oswestry dysfunction index (Oswestry disability index,ODI) and vertebral height before and after operation. Results Bone cement leakage occurred in 9 vertebrae (40.9%), including 5 cases of upper and lower endplate leakage, 2 cases of vertebral canal, 1 case of paravertebral vertebra and 1 case of paraspinal rib. The follow-up time was 6 ~ 32 months (mean 23 months). Pain was significantly improved on the first day after VAS and ODI [vs. before operation] On the first day after operation: (7.2 鹵0. 8) vs. (3.3 鹵0. 8); 70.8% 鹵7.5vs.25.8% 鹵7.5t = 24.26P0.0.The last follow-up continued to improve [(1.9 鹵0.9) points, t 7.88 P 0.000% 鹵5.4t 6.18g P0. 00]. The height of the anterior, middle and posterior edge of the diseased vertebral body increased significantly on the first day after operation [(16.4 鹵6.0) mm vs. (19.1 鹵6.5) mm,t=-4.88,P=0.00;]. (14.5 鹵4.4) mm vs. (19.6 鹵5.4) mm,t=-5.53,P=0.00; (23.9 鹵5.3) mm vs. (27.4 鹵5.8 mm,t=-5.33,P=0.00) and partial loss at the last follow-up [(18.2 鹵6.4) mm,t=6.44,P=0.00; (18.2 鹵5.0) mm,t=4.87,P=0.00;] (26.2 鹵5.4) mm,t=4.70,P=0.00]. On the first day after operation, the Cobb angle decreased significantly (16.7 擄鹵7.4 擄vs.13.1 擄鹵5.5 擄, t = 4.39 vs.13.1 鹵5.00), and the partial loss was (16.2 擄鹵5.7 擄, t ~ (-5.77) at the last follow-up. P0.00) Conclusion the treatment of osteoporotic vertebral compression fracture with pouch compression vertebroplasty can significantly relieve pain and recover vertebral body height.
【作者單位】： 重慶醫(yī)科大學(xué)附屬第一醫(yī)院骨科;
【基金】：國(guó)家自然科學(xué)基金(項(xiàng)目編號(hào):81272171)
【分類號(hào)】：R687.3

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