中国骨伤2026，Vol.39Issue(2)：122-129,8.DOI:10.12200/j.issn.1003-0034.20250663
经皮椎体-椎弓根成形术在骨质疏松椎体压缩骨折的应用研究
Application of percutaneous vertebro-pedicle plasty in osteoporotic vertebral compression fractures
摘要
Abstract
Objective To explore the clinical efficacy of percutaneous vertebro-pediculoplasty(PVPP)versus traditional percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fractures(OVCF)of the thoracolum-bar spine.Methods A retrospective analysis was performed on 87 OVCF patients admitted from January 2020 to January 2023.They were divided into the PVPP group(40 cases)and PVP group(47 cases)according to the surgical method.The PVPP group included 5 males and 35 females,aged from 61 to 82 years with an average of(77.91±6.83)years,body mass index(BMI)of(23.89±3.10)kg.m-2,bone mineral density T-value of(-3.13±0.57),and disease course of(11.53±4.16)days.The PVP group included 7 males and 40 females,aged from 62 to 83 years with an average of(75.58±7.35)years,BMI of(23.52±2.84)kg·m-2,bone mineral density T-value of(-3.21±0.65),and disease course of(10.25±3.57)days.Perioperative indicators,vi-sual analogue scale(VAS),Oswestry disability index(ODI),anterior vertebral height,Cobb angle of the injured vertebra,and complication rate were observed and compared between two groups.Results All patients were followed up,with a follow-up pe-riod of(13.85±2.01)months in the PVPP group and(14.16±2.74)months in the PVP group.The operation time of the PVPP group was(45.61±8.33)minutes,which was longer than that of the PVP group(38.25±7.18)minutes,with a statistically sig-nificant difference(P＜0.001).The bone cement injection volume of the PVPP group was(4.98±0.96)ml,which was higher than that of the PVP group(3.91±0.82)ml,with a statistically significant difference(P＜0.05).The VAS of both groups at 1 day,3 months,and 1 year after operation were improved compared with those before operation(Ftime=528.47,P＜0.001;Fgroup=12.76,P=0.001;Finteraction=3.24,P=0.022).The ODI percentages of both groups at 1 day,3 months,and 1 year after operation were significantly improved compared with those before operation(P＜0.05),and the ODI percentages of the PVPP group at 3 months and 1 year after operation were lower than those of the PVP group(P＜0.05).The anterior vertebral height of both groups at 1 day,3 months,and 1 year after operation was significantly restored compared with that before operation(P＜0.05);there was a statistically significant difference in the loss rate of anterior vertebral height between two groups(P＜0.001).The Cobb angles of both groups at 1 day,3 months,and 1 year after operation were significantly smaller than those before operation(P＜0.05);there were statistically significant differences in the Cobb angles between the two groups at 3 months and 1 year after operation(P＜0.001).PVPP was significantly superior to PVP in height maintenance(F=15.27,P＜0.001)and angle control(F=12.83,P＜0.001).The refracture rate of the affected vertebra in the PVPP group was 2.50％(1/40),and the fracture rate of adjacent vertebrae was 5.00％(2/40),which were significantly lower than those in the PVP group[14.89％(7/47)and 17.02％(8/47)],with statistically significant differences(P＜0.05).Conclusion PVPP is superior to PVP in long-term pain control,maintenance of vertebral stability,and reduction of refracture risk.It is especially suitable for patients with pedicle mi-crofractures or high osteoporosis risk,providing a more optimized minimally invasive strategy for the treatment of OVCF.关键词
脊柱骨折/骨质疏松骨折/椎体/压缩性骨折/经皮椎体成形术/骨水泥Key words
Spinal fractures/Osteoporotic fractures/Vertebral body/Compression fractures/Percutaneous verte-broplasty/Bone cements分类
医药卫生引用本文复制引用
何升华,冯华龙,付远飞,谭黄圣,蓝志明,李盖,蒋勇,赖居易..经皮椎体-椎弓根成形术在骨质疏松椎体压缩骨折的应用研究[J].中国骨伤,2026,39(2):122-129,8.基金项目
国家自然科学基金面上项目(编号:82174397) （编号:82174397）
广东省中医药局面上项目(编号:20251311) （编号:20251311）
深圳市科技计划面上项目(编号:JCYJ20230807094608017) （编号:JCYJ20230807094608017）
深圳市"医疗卫生三名工程"项目(编号:SZZYSM202211004)National Natural Science Foundation of China(No.82174397) （编号:SZZYSM202211004）
