国际医药卫生导报2025，Vol.31Issue(9)：1415-1420,6.DOI:10.3760/cma.j.cn441417-20240710-09002
改良PVP治疗老年中段胸椎OVCF合并退变性脊柱疾病患者的效果
Efficacy of modified PVP in the treatment of senile patients with mid-thoracic OVCF complicated with degenerative spinal disease
摘要
Abstract
Objective To investigate the effect of CT-guided modified unilateral pedicle approach vertebroplasty(PVP)in the treatment of senile patients with osteoporotic vertebral compression fracture(OVCF)of mid-thoracic vertebra(T5-T9)and degenerative spinal disease.Methods A retrospective analysis was performed on 105 elderly patients with mid-thoracic vertebra(T5-T9)OVCF complicated with degenerative spinal disease admitted to Shaanxi Nuclear Industry 215 Hospital from February 2019 to May 2022.They were divided into a study group(63 cases)and a control group(42 cases)according to different approaches.In the control group,there were 6 males and 36 females,aged(76.81±5.74)years,and the course of disease was(12.51±4.72)d.In the study group,there were 8 males and 55 females,aged(76.27±5.93)years,and the course of disease was(12.93±4.30)d.The study group received modified CT-guided PVP,and the control group received bilateral transpedicle approach vertebroplasty.The perioperative conditions,pain,imaging parameters,biomechanical indexes,and complications were compared between the two groups.Repeated measure ANOVA,independent sample t test,and x2 test were used for statistical analysis.Results The operation time of the study group was longer than that of the control group[(48.50±6.45)min vs.(37.13±5.32)min],and the intraoperative X-ray exposure times and hospitalization cost were lower than those of the control group[(17.35±2.59)times vs.(21.23±3.68)times,(1.91±0.28)million yuan vs.(2.45±0.37)million yuan](all P＜0.05).There was no statistically significant difference in the amount of blood loss,injection amount of bone cement,distribution of bone cement,postoperative ambulation time,or hospital stay between the two groups(all P＞0.05).The Visual Analogue Scale(VAS)scores of the study group and the control group were(1.32±0.28)points and(1.39±0.31)points one year after surgery,which were lower than those before surgery and one month after surgery(all P＜0.05);the anterior edge heights of the injured vertebra in the study group and the control group were(22.48±3.76)mm and(22.72±3.98)mm,and the posterior edge heights of the injured vertebra were(37.85±5.73)mm and(37.64±5.30)mm,which were higher than those before surgery and one month after surgery(all P＜0.05);the local Cobb angles were(10.14±1.78)° and(10.38±1.70)°,which were lower than those before surgery and one month after surgery(all P＜0.05).There was no statistically significant difference in the total incidence of complications between the control group and the study group[28.6％(12/42)vs.22.2％(14/63)](P＞0.05).Conclusion In elderly patients with mid-thoracic vertebrae(T5-T9)OVCF complicated with degenerative spinal disease,CT-guided modified PVP can effectively improve the biomechanical function,reduce the degree of pain,and save the hospitalization costs,but it has a certain learning curve.关键词
骨质疏松性椎体压缩骨折/退变性脊柱疾病/改良单侧椎弓根入路椎体成形术/双侧经椎弓根入路椎体成形术Key words
Osteoporotic vertebral compression fracture/Degenerative spinal disease/Modified unilateral pedicle approach vertebroplasty/Bilateral transpedicle approach vertebroplasty引用本文复制引用
张博,张斌..改良PVP治疗老年中段胸椎OVCF合并退变性脊柱疾病患者的效果[J].国际医药卫生导报,2025,31(9):1415-1420,6.基金项目
陕西省重点研发计划(2020SF-187) Shaanxi Province Key Research and Development Plan(2020SF-187) （2020SF-187）
