不同剂量骨水泥PKP联合雌激素对绝经后女性骨质疏松性腰椎体压缩性骨折患者的影响

目的探讨不同剂量骨水泥PKP联合雌激素对绝经后女性骨质疏松性腰椎体压缩性骨折患者的影响。方法选取2015年1月至2018年6月我院收治的120例老年女性骨质疏松性腰椎体压缩性骨折患者为研究对象,按行PKP手术治疗时骨水泥注入的剂量不同分为三组(A组2-4 mL、B组4-5 mL、C组5-6 mL),所有患者均随访1年,比较术后三组患者VAS评分、ODI评分、伤椎椎体前缘高度、椎体中部高度及并发症的发生率。结果三组患者相比,治疗前VAS评分、ODI评分组间比较差异无显著性(P>0.05);术后3天及1年后随访时,三组患者各项指标均较治疗前显著改善,组内比较差异具有显著性(P<0.05),组间比较差异无显著性(P>0.05);治疗前伤椎椎体前缘高度及椎体中部高度组间比较差异无显著性(P>0.05);术后3天及1年后随访时,三组患者治疗后椎体前缘、中间高度均较术前明显增加(P<0.05),组间比较椎体前缘高度:C组>B组>A组,椎体中间高度:C组>B组>A组,且组间比较有统计学差异(P<0.05); A组患者并发症的发生率(12.5%)明显低于B组(30.0%)、C组(41.0%),有统计学差异(P<0.05)。结论 PKP术中注入小剂量骨水泥(2-4 mL)对于治疗老年女性OVCFs具有良好的治疗效果及较高的安全性。

Effects of different doses of bone cement PKP combined with estrogen on postmenopausal women with osteoporotic lumbar vertebral compression fracture

Objective To investigate the effects of different doses of bone cement PKP combined with estrogen on postmenopausal women with osteoporotic lumbar vertebral compression fracture. Methods 120 elderly female patients with osteoporotic lumbar vertebral compression fractures admitted to our hospital from January 2015 to June 2018 were divided into three groups(group A 2~4 ml,group B 4~5 mL,group C 5~4 mL)according to the dosage of bone cement injected during PKP operation. All patients were followed up for one year and compared with the third group after operation. The VAS score, ODI score,the anterior height of injured vertebral body,the middle height of vertebral body and the incidence of complications were recorded. Results There was no significant difference in VAS score and ODI score between the three groups before treatment(P>0.05);at the follow-up of three days and one year after operation,all the indexes of the three groups were significantly improved compared with those before treatment(P<0.05),and there was no significant difference between the three groups(P>0.05). There was no significant difference in the anterior and middle height of vertebral body before treatment (P>0.05);the anterior and middle height of vertebral body increased significantly after three days and one year follow-up(P<0.05). The anterior height of vertebral body in group C>group B>group A,and the intervertebral height in group C>group B were significantly higher than that before treatment(P<0.05). The incidence of complications in group A(12.5%)was significantly lower than that in group B(30.0%) and group C(41.0%)(P<0.05). Conclusion Intraoperative injection of low dose bone cement(2~4 ml) in PKP is effective and safe for the treatment of OVCFs in elderly women.