| 定向骨水泥导向器治疗胸腰椎压缩骨折的疗效分析及影像学研究 |
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Received:April 15, 2019
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| 作者 | Author | 单位 | Unit | E-Mail |
| 周晓吉 |
ZHOU Xiao-ji |
南京医科大学第一附属医院, 江苏 南京 210000
中国人民解放军联勤保障部队第904医院, 江苏 无锡 214000 |
The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China |
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| 刘永涛 |
LIU Yong-tao |
南京医科大学第一附属医院, 江苏 南京 210000 |
The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China |
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| 李宏 |
LI Hong |
中国人民解放军联勤保障部队第904医院, 江苏 无锡 214000 |
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| 曹晓建 |
CAO Xiao-jian |
南京医科大学第一附属医院, 江苏 南京 210000 |
The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China |
xiaojiancao001@163.com |
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| 期刊信息：《中国骨伤》2019年32卷，第7期，第624-629页 |
| DOI：10.3969/j.issn.1003-0034.2019.07.008 |
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目的：应用定向骨水泥导向器行单侧椎体后凸成形术（PKP）治疗骨质疏松性椎体压缩骨折，观察骨折椎体内骨水泥分布规律及临床疗效。
方法：回顾性分析2016年7月至2018年7月收治的211例（211椎）骨质疏松性椎体压缩骨折（OVCFs）患者的临床资料，所有患者采用PKP治疗，其中102例应用定向骨水泥导向器（观察组），男30例，女72例，年龄（68.4±8.9）岁；109例应用常规骨水泥导向器（常规组），男32例，女77例，年龄（70.4±9.2）岁。观察两组患者手术时间、骨水泥量、疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、骨水泥的分布及渗漏情况、病椎Cobb角改善率。
结果：两组患者性别、年龄及病椎分布比较差异均无统计学意义（P>0.05）。两组患者手术时间、骨水泥量、VAS评分、ODI评分、Cobb角改善率组间相比差异无统计学意义（P>0.05）。观察组渗漏10个椎体，渗漏率为9.80%，常规组渗漏11个椎体，渗漏率为10.09%，两组差异无统计学意义（P>0.05）。观察组中椎体骨水泥I-Ⅳ度分布比例分别为60.78%、19.61%、9.80%、9.80%，常规组中椎体骨水泥Ⅰ-Ⅳ度分布比例分别为39.45%、22.93%、22.93%、14.68%，观察组中骨水泥Ⅰ度分布率明显优于常规组（P<0.05）；两组骨水泥Ⅱ度分布率差异无统计学意义（P>0.05）。自T10至L5骨水泥Ⅰ度分布率两组均呈递减趋势，观察组L1-L5节段骨水泥Ⅰ度分布椎体数占比为50%，高于常规组的30.23%，差异有统计学意义（P<0.05）。
结论：定向骨水泥导向器可控骨水泥弥散方向，达到单侧穿刺、双侧骨水泥有效分布，手术效果满意，用于单侧PKP治疗OVCFs是可行且有效的。 |
| [关键词]:骨质疏松性椎体压缩骨折 单侧椎体后凸成形术 骨水泥分布 定向骨水泥导向器 |
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| Therapeutic effect and imaging study of directional bone cement guide for the treatment of thoracolumbar vertebral compression fracturess |
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Abstract:Objective:To evaluate the therapeutic effects and bone cement distribution of unilateral percutaneous kyphoplasty (PKP) with oriented bone cement injector for thoracolumbar osteoporotic vertebral compression fractures (OVCFs).
Methods:The clinical data of 211 patients (211 vertebrae) with thoracolumbar osteoporotic compression fractures underwent PKP between July 2016 to July 2018 were retrospectively analyzed. All punctures were performed unilaterally:102 patients in observation group used oriented bone cement injector including 30 males and 72 females with an average age of (68.4±8.9)years old;109 patients in regular group used traditional bone cement injector including 32 males and 77 females with an average age of (70.4±9.2) years old. The two groups were compared in terms of duration of operation,cement volume,visual analogue scale(VAS),Oswestry Disability Index(ODI),distribution of bone cement,bone cement leakage and Cobb angle modified rate.
Results:There were no significant difference in gender,age and fracture vertebra between the two groups(P>0.05). No significant difference was found between two groups in duration of operation,cement volume,VAS,ODI and Cobb angle(P>0.05). In observation group,10 cases occurred cement leakages,with leakage rate of 9.80%;and in regular group,11 cases occurred cement leakage,with leakage rate of 10.09%. There was no significant difference in the cement leakage rate between two groups(P>0.05). In observation group,proportion rate of Ⅰ-Ⅳ degree in cement distribution was 60.78%,19.61%,9.80%,9.80%,respectively;while 39.45%,22.93%,22.93%,14.68% in regular group. The Ⅰ degree of cement cross-filling rate was better in observation group than in regular group(P<0.05). There was no significant difference between two groups in Ⅱdegree distribution rate of bone cement(P>0.05). From T10 to L5,Ⅰ degree bone cement distribution rate of both groups showed decline trend. The Ⅰ degree cement cross-filling rate in L1-L5 was 50% in observation group and 30.23% in regular group(P<0.05).
Conclusion:Oriented bone cement injector can control the direction of bone cement dispersion and achieve effective distribution of bilateral bone cement using unilateral puncture and satisfactory surgical results. It is feasible and effective for unilateral PKP treatment of OVCFs. |
| KEYWORDS:Osteoporotic vertebral compression fractures Unilateral percutaneous kyphoplasty Bone cement distribution Oriented bone cement injector |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 周晓吉,刘永涛,李宏,曹晓建.定向骨水泥导向器治疗胸腰椎压缩骨折的疗效分析及影像学研究[J].中国骨伤,2019,32(7):624~629 |
| 英文格式: | ZHOU Xiao-ji,LIU Yong-tao,LI Hong,CAO Xiao-jian.Therapeutic effect and imaging study of directional bone cement guide for the treatment of thoracolumbar vertebral compression fracturess[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(7):624~629 |
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