精准骨折线穿刺椎体成形术在骨质疏松性椎体压缩骨折治疗中的应用

目的 比较传统经皮椎体成形术(PVP)与精准骨折线穿刺椎体成形术在骨质疏松性椎体压缩骨折的临床效果。方法 采用回顾性对照研究分析2015年1月—2017年10月收治的112例骨质疏松性椎体压缩骨折患者临床资料,按随机数表法将其分为观察组和对照组,每组56例。对照组采用常规椎体成形术,观察组应用精准骨折线穿刺技术。在术前、术后第1天、术后第3天对患者进行VAS评分。观察手术时间、骨水泥注入量、椎体内骨水泥充盈、渗漏情况。 结果 观察组患者手术后第1天、第3天的VAS评分明显低于对照组,差异均有统计学意义(P<0.05);观察组骨折区域均得到充足骨水泥填充,对照组有8例出现填充不充分,差异均有统计学意义(P<0.05);两组手术时间、骨水泥注入量及骨水泥渗漏率比较差异均无统计学意义(P>0.05)。结论 与传统经皮椎体成形术相比,精准骨折线穿刺椎体成形术,更能保证骨水泥在骨折区域充分填充,减少术后疗效不佳的发生,是一种安全、有效的新技术。

Application of accurate fracture line injection vertebroplasty in vertebral osteoporotic fracture

Objective To compare the clinical effect between traditional percutaneous vertebroplasty(PVP)and precise fracture line puncture vertebroplasty in the treatment of osteoporotic vertebral compression factures (OVCFs).Methods A retrospective controlled study was designed to review 112 cases of single level OVCFs hospitalized from January 2015 to October 2017.The patients were divided into the observation group and the control group according to random number table method, with 56 cases in each group.The control group was treated with conventional vertebroplasty , and the observation group was treated with precise fracture line puncture. Visual analogue score (VAS) were performed before the surgery and at 1 d,3 d after surgery.Operating time,cement injection volume,rate of cement leakage,cement distribution in the fractured area and VAS of back pain were compared between the two groups.Results At 1 d、3 d after surgery, the VAS of the observation group was significantly lower than that in the control group(P<0.05). In the observation group, the fracture area was filled with sufficient bone cement, and 8 cases in the control group showed insufficient filling. The difference was statistically significant (P<0.05). There were no significant differences in operating time, cement injection volume and rate of cement leakage between the two groups(P>0.05). Conclusion Compared with traditional percutaneous vertebroplasty, precise fracture line puncture vertebroplasty can ensure the full filling of bone cement in the fracture area and reduce the occurrence of poor postoperative efficacy. It is a safe and effective new technology.