| 喻子林,范春杨,王家乐,毛海青*.经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折手术时机的选择[J].脊柱外科杂志,2024,22(6):399-404. |
经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折手术时机的选择  点此下载全文 (Fulltext) |
| 喻子林 范春杨 王家乐 毛海青* |
| 苏州大学第一附属医院骨科, 苏州 215006 |
| 基金项目： |
| DOI：10.3969/j.issn.1672-2957.2024.06.008 |
| 摘要点击次数: 235 |
| 全文下载次数: 69 |
| 摘要： |
| 目的 探讨经皮椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折（OVCF）的手术时机。方法 回顾性分析2022年1月—2022年12月采用PKP治疗的238例OVCF患者临床资料，根据从受伤到住院时间不同分为3组，早期组（骨折4周内手术）、中期组（骨折4~8周手术）、晚期组（骨折8周后手术）。在侧位X线片上测量伤椎前缘、中部高度，伤椎Cobb角及楔形角，并计算伤椎前缘、中部压缩率和高度恢复率。于术前、出院前、术后6个月采用疼痛视觉模拟量表（VAS）评分评估疼痛程度，采用Oswestry功能障碍指数（ODI）评估腰椎功能。并记录骨水泥渗漏发生情况。结果 骨水泥渗漏发生率为6.3%。早期组术后1 d、6个月的伤椎前缘压缩率低于中、晚期组，术后6个月的椎体前缘高度恢复率优于中、晚期组，差异均有统计学意义（P <0.05）。早期组术后1 d的椎体中部压缩率低于中、晚期组，术后1 d伤椎中部高度恢复率优于中、晚期组，差异均有统计学意义（P <0.05）。早期组术后1 d、6个月伤椎Cobb角、楔形角较术前明显改善，差异均有统计学意义（P <0.05）。早期组Cobb角和楔形角变化值优于中、晚期组，差异均有统计学意义（P <0.05）。3组患者各随访时间点VAS评分和ODI较术前明显改善，差异均有统计学意义（P <0.05）；3组各随访时间点VAS评分和ODI组间差异均无统计学意义（P>0.05）。结论 OVCF患者早期采用PKP治疗能更好地恢复椎体高度和角度，有助于减轻患者痛苦和术后椎体形态的恢复。 |
| 关键词：胸椎 腰椎 骨折,压缩性 骨质疏松 椎体后凸成形术 |
| Selection of surgical timing for percutaneous kyphoplasty in treatment of osteoporotic vertebral compression fractures Fulltext |
| Yu Zilin Fan Chunyang Wang Jiale Mao Haiqing |
| Department of Orthopaedics, First Affiliated Hospital, Soochow University, Suzhou 215006, Jiangsu, China |
| Fund Project: |
| Abstract: |
| Objective To investigate the appropriate timing of surgery for percutaneous kyphoplasty（PKP） in the treatment of osteoporotic vertebral compression fractures（OVCF）. Methods Data of 238 OVCF patients treated with PKP from January 2022 to December 2022 were retrospectively analyzed，and these patients were divided into 3 groups according to the length of time from injury to hospitalization：early group（operation within 4 weeks after fracture），middle group（operation within 4 to 8 weeks after fracture），and late group（operation after 8 weeks after fracture）. The anterior and middle heights of injured vertebrae，Cobb angle and wedge angle of injured vertebrae were measured on lateral roentgenograph，and the compression rate and the recovery rate of the height of injured vertebrae were calculated. At pre-operation，before discharge and at postoperative 6 months，pain intensity was assessed by the visual analog scale（VAS） score，and lumbar function was evaluated with the Oswestry disability index（ODI）. The incidence of bone cement leakage was also recorded. Results The bone cement leakage rate was 6.3%. The compression rate of anterior height of injured vertebrae in the early group was lower than that in the middle and late groups at postoperative 1 d and 6 months，and the recovery rate of anterior height of injured vertebrae at postoperative 6 months was better than that in the middle and late groups，all with a statistical significance（P <0.05）. The compression rate of middle height of injured vertebrae in the early group was lower than that in the middle and late groups at postoperative 1 d，and the recovery rate of middle height of injured vertebrae at postoperative 1 d was better than that in the middle and late groups，all with a statistical significance（P <0.05）. The Cobb angle and wedge angle of the injured vertebrae in the early group were significantly improved at postoperative 1 d and 6 months，with statistical significances（P <0.05）. The change value of Cobb angle and wedge angle in the early group were better than those in the middle and late groups，with statistical significances（P <0.05）. The VAS score and ODI of the 3 groups were significantly improved at each follow-up time point，with statistical significances（P <0.05）. There was no significant difference in VAS score and ODI between the 3 groups at each follow-up time point（P>0.05）. Conclusion Early application of PKP treatment in patients with OVCF can lead to better restoration of vertebral height and alignment，helping to alleviate patient discomfort and improve postoperative vertebral morphology. |
| Keywords:Thoracic vertebrae Lumbar vertebrae Fractures,compression Osteoporosis Kyphoplasty |
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