选择性PVP对多节段骨质疏松伴胸腰椎骨折患者的治疗效果观察OA
Observation on the Therapeutic Effect of Selective PVP on Patients with Multi-Segment Osteoporosis with Thoracolumbar Fractures
目的:探讨选择性经皮椎体成形术(PVP)治疗多节段骨质疏松伴胸腰椎骨折的临床效果.方法:回顾性分析2021年 1月—2023年 3月于阳春市中医院接受选择性PVP治疗的 35例多发骨质疏松伴胸腰椎骨折患者资料.记录患者的手术指标、功能障碍及疼痛情况、并发症发生情况.结果:患者平均手术时间 45.95 min,平均骨水泥注入量 10.92 mL.术中出现骨水泥渗漏 5例,占比 14.29%,其中 2例向椎间隙渗漏,其余 3例向椎旁两侧渗漏,发生渗漏的患者均无明显临床症状.术后 6个月随访期内保守治疗椎体无再发骨折或骨折加重,未发现其他节段有新发的椎体骨质疏松性压缩骨折.术后 2 d、6个月,患者的Oswestry功能障碍指数(ODI)评分及疼痛视觉模拟法(VAS)评分均低于术前,差异均有统计学意义(P<0.05);术后 6个月,患者的ODI评分及VAS评分与术后 2 d比较,差异均无统计学意义(P>0.05).患者术后并发症发生率为 8.57%.结论:术前仔细阅片并评估,根据患者临床症状、体征、椎体骨折形态及水肿严重程度等,采用选择性PVP治疗多节段骨质疏松性胸腰椎骨折能减轻其胸腰背部疼痛、障碍程度,对患者早日康复具有积极意义.
Objective:To explore the clinical effect of selective percutaneous vertebroplasty(PVP)in the treatment of multi-segment osteoporosis with thoracolumbar fractures.Methods:A data of 35 patients with multi-segment osteoporosis with thoracolumbar fractures who received selective PVP treatment at Yangchun Hospital of Traditional Chinese Medicine from January 2021 to March 2023 were retrospectively analyzed.The surgical indicators,functional impairment and pain conditions,as well as the occurrence of complications of the patients were recorded.Results:The average operation time was 45.95 minutes and the average injection volume of bone cement was 10.92 mL.During surgery,bone cement leakage occurred in 5 cases,accounting for 14.29%.Among them,2 cases leaked to the intervertebral space,and the remaining 3 cases leaked to both sides of the parvertebrae.None of the patients with leakage had obvious clinical symptoms.During the 6-month follow-up period after surgery,conservative treatment showed no recurrence of vertebral fractures or fracture aggravation,and no new osteoporotic compression fractures of the vertebral body were found in other segments.2 days and 6 months after surgery,the Oswestry Disability Index(ODI)scores and the Pain Visual Analogue Scale(VAS)scores of the patients were lower than those before surgery,the differences were statistically significant(P<0.05);6 months after surgery,there were no statistically significant differences in the ODI score and VAS score of the patients compared with those at 2 days after surgery(P>0.05).The incidence of postoperative complications in patients is 8.57%.Conclusion:Careful preoperative film reading and evaluation,based on the patient's clinical symptoms,signs,morphology of vertebral fractures and severity of edema,etc.,the adoption of selective PVP in the treatment of multi-segment osteoporosis with thoracolumbar fractures can alleviate their thoracolumbar and lumbar pain and degree of dysfunction;has positive significance for the early recovery of patients.
邹信明;黄振原;黄海翔;何荣龙;李浩;刘权锋
广东省阳春市中医院骨三科,广东 阳江 529500广东省阳春市中医院骨三科,广东 阳江 529500广东省阳春市中医院骨三科,广东 阳江 529500广东省阳春市中医院骨三科,广东 阳江 529500广东省阳春市中医院骨三科,广东 阳江 529500广东省阳春市中医院骨三科,广东 阳江 529500
医药卫生
骨质疏松胸腰椎骨折选择性经皮椎体成形术临床疗效
OsteoporosisThoracolumbar fracturesSelectivePercutaneous vertebroplastyClinical efficacy
《中国伤残医学》 2025 (10)
6-9,4
阳江市医疗卫生科技计划项目(SF2021169)
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