我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

不同病程的单节段胸腰段严重骨质疏松性椎体压缩性骨折 行PKP手术疗效的对比研究

《创伤外科杂志》[ISSN:/CN:]

期数:
2020年12期
页码:
904-909
栏目:
论著·临床研究
出版日期:
2020-12-20

文章信息/Info

Title:
A comparative study of the efficacy of PKP surgery for severe single segment osteoporotic vertebral compression fractures of thoracolumbar at different periods
文章编号:
1009-4237(2020)12-0904-06
作者:
杨智杰; 刘 渤; 陈 杰; 夏辉强; 张 野; 韩 非; 唐 盼
400016 重庆,重庆医科大学附属第一医院骨科
Author(s):
YANG Zhi-jie; LIU Bo; CHEN Jie; XIA Hui-qiang; ZHANG Ye; HAN Fei; TANG Pan
Department of Orthopaedics,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China
关键词:
椎体压缩骨折;  骨质疏松;  椎体内裂隙征;  骨水泥渗漏;  椎体成形术
分类号:
R 683.2
DOI:
10.3969/j.issn.1009-4237.2020.12.006
文献标识码:
A
摘要:
目的 比较不同时期行经皮椎体后凸成形术(PKP)对单节段胸腰段严重骨质疏松性椎体压缩性骨折(VSOVCF)的手术疗效。方法 回顾性分析2015年1月—2017年7月重庆医科大学附属第一医院骨科收治的符合纳入标准的106例胸腰段VSOVCF患者的临床资料。按病程长短进行分组:A组病程为1周内(26例); B组病程为1～3周(27例); C组病程为3～6周(26例); D组病程为6周以上(27例)。记录并比较各组患者术前与术后即刻、超过2年末次随访时VAS评分、Oswestry功能障碍指数(ODI)、局部后凸角(LKA)和伤椎高度,术中使用骨水泥体积、术后骨水泥渗漏率及相邻椎体骨折发生率,评估疼痛、功能改善情况和并发症发生情况。结果 各组患者年龄、性别、体质指数、骨密度及椎体内裂隙征等术前资料比较,差异均无统计学意义(P>0.05)。各组患者术后即刻和末次随访时VAS评分和ODI均较术前有明显改善(P<0.05),疼痛的改善呈持续性; 但末次随访时A、B两组VAS评分[(2.7±0.5)分、(2.8±0.4)分]和ODI[(36.9±4.1)%、(37.8±3.2)%]明显低于C、D两组[VAS评分分别为(3.2±0.7)分、(3.3±0.4)分,ODI分别为(43.4±3.4)%、(44.7±4.6)%],P<0.05; 各组LKA和伤椎高度在术后即刻均得到显著矫正,末次随访时C、D两组的伤椎高度[(14.4±1.6)mm、(14.6±1.8)mm]明显低于A、B两组[(16.3±0.9)mm、(16.5±0.9)mm](F=9.841,P=0.000),LKA明显大于A、B两组(P<0.05); B组骨水泥渗漏率(26%)较低,明显低于其余各组且与C、D两组(58%、63%)差异有显著统计学意义(χ2=8.705,P=0.033); A、B两组相邻椎体骨折的发生率(8%、7%)明显低于C、D两组(31%、26%),差异有统计学意义(χ2=8.332,P=0.040)。结论 不同病程VSOVCF行PKP术后即刻效果相似,病程3周以内的患者在中远期随访获得相对更好的持续效果,3周以后行PKP手术可能会增加骨水泥渗漏和相邻椎体骨折风险。

参考文献/References

[1] Lee JK,Jeong HW,Joo IH,et al.Percutaneous balloon kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures: a case-control study[J].Spine J,2018,18(6):962-969.
[2] 中华人民共和国国家统计局.中国统计年鉴[M].北京:中国统计出版社,2017.
[3] Takahashi S,Hoshino M,Terai H,et al.Differences in short-term clinical and radiological outcomes depending on timing of balloon kyphoplasty for painful osteoporotic vertebral fracture[J].J Orthop Sci,2018,23(1):51-56.
[4] Yang CC,Chien JT,Tsai TY,et al.Earlier vertebroplasty for osteoporotic thoracolumbar compression fracture may minimize the subsequent development of adjacent fractures: a retrospective study[J].Pain Physician,2018,21(5):E483-E491.
[5] 丁克海,纪标,周其佳,等.胸腰椎体压缩性骨折行椎体后凸成形注射骨水泥的治疗时机[J].中国组织工程研究,2015,19(43):6962-6965.
[6] Wang H,Zhang Z,Liu Y,et al.Percutaneous kyphoplasty for the treatment of very severe osteoporotic vertebral compression fractures with spinal canal compromise[J].Orthop Surg Res,2018,13(1):13.
[7] Wang F,Wang LF,Miao DC,et al.Which one is more effective for the treatment of very severe osteoporotic vertebral compression fractures: PVP or PKP[J].J Pain Res,2018,11:2625-2631.
[8] Liu T,Li Z,Su Q.Cement leakage in osteoporotic vertebral compression fractures with cortical defect using high-viscosity bone cement during unilateral percutaneous kyphoplasty urgery[J].Medicine,2017,96(25):e7216.
[9] Li Z,Liu T,Yin P,et al.The therapeutic effects of percutaneous kyphoplasty on osteoporotic vertebral compression fractures with or without intravertebral cleft[J].Int Orthop,2019,43(2):359-365.
[10] Biamonte F,Rao SD,Cipriani C,et al.Multiple vertebral osteonecroses(Kmmell's disease)after 10 years on denosumab: os osteocyte apoptosis to blame more evidence needed[J].Calcif Tissue Int,2018,103(1):109-110.
[11] Chongyan W,Zhang X,Li S,et al.Mechanism of formation of intravertebral clefts in osteoporotic vertebral compression fractures: an in vitro biomechanical study[J].Spine J,2018,18(12):2297-2301.
[12] 姚仕奋,谢惠缄,陈民.经皮椎体后凸成形术不同手术时机治疗骨质疏松性椎体压缩性骨折的疗效观察[J].中国矫形外科杂志,2015,23(18):1662-1666.
[13] Sun YC,Teng MM,Yuan WS,et al.Risk of post-vertebroplasty fracture inadjacent vertebral bodies appears correlated with the morphologic extent of bone cement[J].J Chin Med Assoc,2011,74(8):357-362.
[14] Trout AT,Kallmes DF,Lane JI,et al.Subsequent vertebral fractures after vertebroplasty: association with intraosseous clefts[J].AJNR,2006,27(7):1586-1591.
[15] Yu W,Jiang X,Liang null,et al.Intravertebral vacuum cleft and its varied locations within osteoporotic vertebral compression fractures: effect on therapeutic efficacy[J].Pain Physician,2017,20(6):E979-E986.
[16] He X,Meng Y,Huang Y,et al.Factors affecting delayed union of vertebral fractures following percutaneous kyphoplasty[J].Pain Physician,2017,20(2):E241-E249.
[17] Denoix E,Viry F,Ostertag A,et al.What are the predictors of clinical success after percutaneous vertebroplasty for osteoporotic vertebral fractures[J].Eur Radiol,2018,28(7):2735-2742.
[18] Movrin I.Adjacent level fracture after osteoporotic vertebral compression fracture: a nonrandomized prospective study comparing balloon kyphoplasty with conservative therapy[J].Wien Klin Wochenschr,2012,124(9-10):304-311.
[19] Yu WB,Jiang XB,Liang D,et al.Risk factors and score for recollapse of the augmented vertebrae after percutaneous vertebroplasty in osteoporotic vertebral compression fractures[J].Osteoporos Int,2019,30(2):423-430.
[20] 杨俊龙,刘志祥,赖震,等.经皮椎体球囊扩张成形术不同手术时机对胸腰椎骨质疏松性压缩性骨折疗效的影响[J].创伤外科杂志,2017,19(7):484-487.

备注/Memo

备注/Memo:
【通信作者】 刘渤,E-mail:boliucqmu@qq.com
更新日期/Last Update: 2020-12-20