三维多角度应力强化灌注PVP手术治疗老年骨质疏松椎体压缩性骨折疗效分析OA

Objective To evaluate the actual therapeutic effect of percutaneous vertebroplasty(PVP)under three-dimensional and multi-angle stress-enhanced perfusion on elderly osteoporotic vertebral compression fractures(OVCF).Methods A prospective study was conducted on 89 elderly OVCF patients admitted to the orthopedic ward of the Central Hospital of Jiaomei Coal Industry(Group)Co,Ltd.from March 2022 to March 2023.All patients underwent PVP surgery in the hospital.According to the computer random number table method,the patients were randomly divided into control group(n=45)and experimental group(n=44).The control group was treated with conventional PVP,while the experimental group was treated with three-dimensional multi angle perfusion method that targeted the fracture site through the pedicle and enhanced bone cement perfusion on the stress side of the vertebral fracture line.Following up for 6 months.The Oswestry functional index,bone density,Cobb angle,lower limb walking ability,and treatment effectiveness between two groups before and after treatment were compared.After the follow-up,the incidence of adverse reactions during the treatment and follow-up period(secondary fractures,bone cement leakage,and persistent stressful pain of the lumbar spine)was calculated for both groups.Results The Oswesty functional index and Cobb angle significantly decreased after treatment in both groups,and the T-value of bone density,maximum walking speed of 10 meters,and average step length were significantly higher than those before treatment,with statistical significance(P＜0.05).The Oswesty functional index(39.95±8.24)in the experimental group was significantly lower than that in the control group(43.55±8.39),and the difference was statistically significant(P＜0.05).After treatment,the bone density T values of the control group and the experimental group were(-1.05±0.13)and(-1.56±0.11),respectively;The Cobb angles are(11.55±2.01)° and(10.53±1.55)°,respectively;The maximum walking speed of 10 meters is(0.63±0.11)m/s and(0.86±0.19)m/s;The average step size is(0.68±0.09)m and(0.79±0.10)m.After treatment,the effective rate of the experimental group(93.18%)was significantly higher than that of the control group(77.78%),and the difference was statistically significant(P＜0.05).After treatment,the incidence of adverse reactions in the experimental group[9.09%(4/44)]was significantly lower than that in the control group[20.00%(9/45)],and the difference was not statistically significant(χ2 = 2.142,P = 0.143).Conclusion Three-dimensional multi angle stress enhanced perfusion PVP surgery can significantly improve spinal function indicators and enhance lower limb walking ability in elderly patients with osteoporotic vertebral compression fractures.It can effectively increase bone density and has certain clinical safety.