| 骨水泥分布与经皮椎体成形术后腰背部残余痛的临床观察 |
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投稿时间：2024-07-08
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| 作者 | Author | 单位 | Address | E-Mail |
| 于东方 |
YU Dong-fang |
郑州市骨科医院, 河南 郑州 450052 |
Zhengzhou Orthopaedics Hospital, Zhengzhou 450052, Henan, China |
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| 王祥善 |
WANG Xiang-shan |
郑州市骨科医院, 河南 郑州 450052 |
Zhengzhou Orthopaedics Hospital, Zhengzhou 450052, Henan, China |
13838076078@163.com |
| 寇德鹏 |
KOU De-peng |
郑州市骨科医院, 河南 郑州 450052 |
Zhengzhou Orthopaedics Hospital, Zhengzhou 450052, Henan, China |
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| 曹顺海 |
CAO Shun-hai |
郑州市骨科医院, 河南 郑州 450052 |
Zhengzhou Orthopaedics Hospital, Zhengzhou 450052, Henan, China |
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| 期刊信息：《中国骨伤》2024年，第37卷，第11期，第1075-1079页 |
| DOI：10.12200/j.issn.1003-0034.20240333 |
| 基金项目: |
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中文摘要:
目的: 探讨骨水泥分布对经皮椎体成形术(percutaneous vertebra plasty,PVP)术后腰背部残余痛的影响。
方法: 选取2017年1月至2020年12月65例因骨质疏松症导致的椎体压缩骨折,根据术后胸腰椎正位X线片显示的骨水泥分布情况分为两组:骨水泥未超过椎体中线,骨水泥分布偏一侧组(偏一侧组)20例,男9例,女11例;年龄60~84(70.3±7.4)岁。骨水泥超过椎体中线并达对侧椎弓根内缘(双侧组)45例,男10例,女35例;年龄60~86(70.7±8.0)岁。两组患者均行PVP术,单侧椎弓根入路穿刺,术中透视监视下注入骨水泥,骨水泥注入量1.5~6 m1。观察比较两组患者骨水泥注入量,术前及术后1 d、1个月、3个月的疼痛视觉模拟评分(visual analogue scale,VAS)。
结果: 偏一侧组骨水泥注入量为(4.25±0.99) ml,双侧组为(4.07±1.18) ml,两组差异无统计学意义(P>0.05)。两组术后疼痛VAS均较术前缓解(P<0.05),偏一侧组术后1 d、1个月、3个月VAS分别为(3.90±1.37)、(2.35±0.67)、(1.55±0.51)分,均高于双侧组(2.67±0.60)、(1.62±0.58)、(1.31±0.47)分(P<0.05)。偏一侧组9例存在残余腰背痛,经对侧椎弓根穿刺,注入骨水泥后症状缓解。
结论: 骨水泥的分布是影响PVP术后腰背部残余痛的一个重要因素,临床手术中,要尽量使骨水泥分布过椎体中线,达到双侧分布均匀。 |
| 【关键词】椎体压缩骨折 经皮椎体成形术 骨水泥分布 |
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| Study on the effect of the distribution of bone cement of residual back pain after percutaneous vertebra plasty |
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ABSTRACT
Objective To investigate the effect of bone cement distribution on efficacy of residual back pain after percutaneous vertebra plasty(PVP).
Methods From January 2017 to December 2020,a total of 65 cases with single segment osteoporotic thoracolumbar vertebral fractures underwent parallel vertebroplasty surgery. On the basis of the postoperative X-ray films of bone cement distribution were divided into two groups. The bone cement was biased to the lateral side of the vertebral body (partial group,20 cases),there were 9 males and 11 famales with an average age of (70.3±7.4) years old ranging from 60 to 84 years old. The bone cement was over the vertebral midline,and completely filled with contralateral vertebral body (bilateral group,45 cases),there were 10 males and 35 famales with an average age of (70.7±8.0) years old ranging from 60 to 86 years old. All of them underwent PVP surgery,bone cement was injected into the vertebral body through paitail transpedicular approach. The amount of bone cement injection,the visual analogue scale(VAS) of preoperation and 1 day,1 month,3 months after surgery between two groups were observed and compared.
Results The amount of cement injection was (4.25±0.99) ml in the partial group,and (4.07±1.18) ml in the bilateral group,there was no significant difference between two groups (P>0.05). Postoperative pain was relieved than preoperative pain (P<0.05),the VAS of 1 day,1 and 3 months after operation (3.90±1.37),(2.35±0.67) and (1.55±0.51) in the partial group were higher than (2.67±0.60),(1.62±0.58) and (1.31±0.47) in the bilateral group (P<0.05). There were 9 cases in partial group,the pain was not relieved due to unfilled cement until the contralateral bone was injected into the bone cement.
Conclusion The distribution of bone cement is one of the main factors affecting residual back pain after PVP,and in the clinical,we should make sure the distribution of bone cement over the midline of vertebral body. |
| KEY WORDS Vertebral compression fracutures Percutaneous vertebra plasty Bone cement distribution |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 于东方,王祥善,寇德鹏,曹顺海.骨水泥分布与经皮椎体成形术后腰背部残余痛的临床观察[J].中国骨伤,2024,37(11):1075~1079 |
| 英文格式: | YU Dong-fang,WANG Xiang-shan,KOU De-peng,CAO Shun-hai.Study on the effect of the distribution of bone cement of residual back pain after percutaneous vertebra plasty[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(11):1075~1079 |
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