骨水泥定向注射技术在椎体成型手术中的应用

目的 探讨骨水泥定向注射技术在椎体成型手术中的应用效果.方法 选择2013年2月至2014年6月于邯郸市冀中能源峰峰集团有限公司总医院骨四科接受治疗的骨质疏松性脊柱骨折患者共116例(126个椎体),按随机数表法将其分为观察组和对照组,每组58例.对照组采用常规椎体成形术,观察组将骨水泥定向注射技术应用于椎体成形术中.在术前、术后第1天、术后第3天及治疗后30个月对患者进行VAS评分.根据X线检查及CT检查,观察伤椎复位情况及椎体内骨水泥充盈、渗漏情况.治疗后比较两组患者的生活质量.结果 两组患者的年龄、性别、随访时间及伤椎比较差异均无统计学意义(P>0.05);观察组患者手术后第1天、第3天、治疗后30个月的VAS评分明显低于对照组,差异均有统计学意义(P<0.05);对照组患者的术后并发症发生率为15.52%,明显高于观察组的8.26%,差异有统计学意义(P<0.05);观察组患者的社会功能、情绪功能、认知功能与对照组比较差异均无统计学意义(P>0.05),而观察组患者的躯体功能评分为(84±9.5)分,明显高于对照组的(56±9.3)分,差异有统计学意义(P<0.05).结论 骨水泥定向注射技术既能够保证术后的止痛效果,还降低了术中发生骨水泥外渗发生的概率,同时降低了骨水泥注射的有效量.

Application of bone cement targeted injection in percutaneous vertebroplasty

Objective To explore the application effect of bone cement targeted injection in directional verte-bral surgery. Methods A total of 116 patients (126 vertebrae) with osteoporotic vertebral fractures, who admitted to our hospital from February 2013 to June 2014, were selected and divided into the observation group and the control group according to random number table method, with 58 cases in each group. The control group was treated with conven-tional vertebroplasty, and bone cement injection technology was used in vertebroplasty in the observation group. VAS scores were performed before the surgery and at 1 d, 3 d, 30 months after surgery. According to X-ray examination and CT observation of vertebral injury, the condition of reduction and the filling and leakage of cement in the vertebral body were observed. The quality of life scores of the two groups after treatment were compared. Results There were no sig-nificant differences between the two groups in age, gender, follow-up time and vertebral injury (P>0.05). At 1 d, 3 d, 30 months after surgery, the VAS scores of the observation group was significantly lower than that in the control group (P<0.05). The incidence of postoperative complications in the control group was 15.52%, which was significantly higher than 8.26%in the observation group (P<0.05). There was no significant difference between the two groups in the patients' so-cial function, emotional function, cognitive function (P>0.05), while the score of body function in the observation group of patients was (84 ± 9.5) points, which was significantly higher than (56 ± 9.3) points in the control group (P<0.05). Conclusion Bone cement targeted injection technique can not only guarantee the analgesic effect, but also reduce the occurrence of bone cement extravasation during the operation and the effective amount of bone cement injection.