国际医药卫生导报2025，Vol.31Issue(9)：前插3,1410-1415,7.DOI:10.3760/cma.j.cn441417-20240506-09001
弯角椎体成形术治疗骨质疏松性椎体压缩骨折的效果评估
Evaluation of the effect of percutaneous corner vertebroplasty in the treatment of osteoporotic vertebral compression fractures
摘要
Abstract
Objective To investigate the changes of serum matrix metalloproteinase inhibitory factor-1(TIMP-1),matrix metalloproteinase-3(MMP-3),and leptin levels and clinical benefits in patients with osteoporotic vertebral compression fractures(OVCF)treated with percutaneous corner vertebroplasty(PCVP).Methods The study was designed using a randomized,prospective,single-center clinical study method.A total of 108 patients with OVCF who received treatment in Xi'an Fifth Hospital from October 2020 to January 2023 were selected and were divided into group A and group B according to the random number table method,with 54 patients in each group.There were 30 males and 24 females in group A,aged 45-71(67.87±3.65)years,injury causes:18 cases of lifting heavy objects,13 cases of traffic accidents,and 23 cases of slips and falls;the time from fracture to operation was 0.5-3.0(1.76±0.54)d.There were 28 males and 26 females in group B,aged 45-72(68.02±3.70)years,injury causes:21 cases of lifting heavy objects,11 cases of traffic accidents,and 22 cases of slips and falls;the time from fracture to operation was 0.7-3.0(1.79±0.58)d.Group A received unilateral percutaneous vertebroplasty(PVP),while group B received PCVP.Both groups were followed up for 6 months after surgery.The bone cement filling effect after 6 months of follow-up,surgical related indicators,anterior vertebral height,Cobb angle of injured vertebra,and lumbar mobility before and after 6 months of follow-up,levels of MMP-3,TIMP-1,and leptin before and 7 d after surgery,and complications were compared between the two groups.x2 test and t test were used for statistical analysis.Results After 6 months of follow-up,the excellent and good rate of bone cement filling in group B was higher than that in group A[94.44％(51/54)vs.81.48％(44/54)],with a statistically significant difference(P＜0.05).The operation time and hospital stay of group B were shorter than those of group A[(21.65±2.54)min vs.(33.65±3.43)min,(8.54±2.54)d vs.(12.54±6.43)d],the number of fluoroscopy times and bone cement dosage were less than those in group A[(13.54±1.98)times vs.(21.43±2.03)times,(23.65±0.32)ml vs.(31.65±2.54)ml],and the effective diffusion ratio of bone cement in group B was higher than that in group A(1.87±0.06 vs.0.99±0.04),with statistically significant differences(all P＜0.05).After 6 months of follow-up,the anterior vertebral height was increased in both groups,and that in group B was higher than that in group A[(95.65±3.43)％vs.(92.12±2.43)％],the Oswestry Disability Index(ODI)and Cobb angle of injured vertebra were decreased in both groups,and those in group B were lower than those in group A[(15.43±4.32)min vs.(19.87±4.98)min,(12.76±2.31)° vs.(14.98±2.89)°],with statistically significant differences(all P＜0.05).Compared with preoperative levels,serum MMP-3 and leptin levels were decreased in both groups 7 d after surgery,and the serum MMP-3 level in group B was lower than that in group A[(21.76±1.65)mmol/L vs.(24.65±1.87)mmol/L];serum TIMP-1 level was increased in both groups,and that in group B was higher than that in group A[(144.76±16.54)μg/L vs.(136.65±17.02)μg/L],with statistically significant differences(all P＜0.05).The incidence of complications in group B was lower than that in group A during follow-up[5.56％(3/54)vs.18.52％(10/54)],with a statistically significant difference(P＜0.05).Conclusion Compared with unilateral PVP,PCVP had advantages such as shorter surgical time and less amount of bone cement used,which can reduce the number of fluoroscopy times,improve the filling effect of bone cement,further regulate the levels of serum MMP-3 and TIMP-1 in patients with OVCF,promote the recovery of the anterior edge height,Cobb angle of the injured vertebra,and lumbar function,and shorten the hospital stay,with high safety.关键词
骨质疏松性椎体压缩骨折/弯角椎体成形术/单侧经皮椎体成形术Key words
Osteoporotic vertebral compression fractures/Percutaneous corner vertebroplasty/Unilateral percutaneous vertebroplasty引用本文复制引用
张桂彬,邓亚军,陈新庆,曹萌,徐剡..弯角椎体成形术治疗骨质疏松性椎体压缩骨折的效果评估[J].国际医药卫生导报,2025,31(9):前插3,1410-1415,7.基金项目
陕西省自然科学基础研究计划(2024JC-YBQN-0924) Shaanxi Province Natural Science Basic Research Program(2024JC-YBQN-0924) （2024JC-YBQN-0924）
