经皮钛网骨水泥填充术治疗老年骨质疏松性椎体压缩性骨折的临床效果

目的　探讨经皮钛网骨水泥填充术治疗老年骨质疏松性椎体压缩性骨折的临床疗效。方法　回顾性分析海阳市人民医院2015年1月至2019年12月收治的147例老年骨质疏松性椎体压缩性骨折的患者，进行病历资料回顾性分析。其中72例患者行经皮钛网骨水泥填充术设为观察组，男34例，女38例，年龄（70.5±10.6）岁，骨密度T值-（3.04±0.04）SD，骨折节段T12 22例、L1 24例、L2 16例、L3 7例、L4 3例；75例患者行弯角椎体成形术设为对照组，男36例，女39例，年龄（71.5±9.6）岁，骨密度T值-（3.07±0.09）SD，骨折节段T12 21例、L1 26例、L2 15例、L3 8例、L4 5例。记录手术时间、骨水泥注入量、透视次数、疼痛视觉模拟量表（VAS）评分、Oswestry功能障碍指数（ODI）评分及椎体前后缘高度比变化情况。计量资料组间比较采用独立样本t检验，计数资料组间比较采用χ²检验。结果　在手术时间及透视次数方面，两组比较差异均无统计学意义（t=1.450、0.184，P=0.149、0.854）；但观察组患者骨水泥注入量明显高于对照组［（6.37±0.55） ml比（3.73±0.27） ml，t=37.169，P<0.001］。两组患者的VAS和ODI评分在术前、术后1个月、术后6个月比较差异均无统计学意义（均P>0.05）；但在末次随访观察组VAS和ODI评分均明显优于对照组（t=3.822、5.373，均P<0.001）。术前、术后1个月及6个月两组患者的椎体恢复程度比较差异均无统计学意义（t=1.227、0.961、1.267，P=0.222、0.338、0.207），观察组在末次随访时椎体高度恢复明显优于对照组（t=14.812，P<0.001）。结论　钛网植入椎体成形术治疗老年骨质疏松性椎体压缩性骨折能够更好恢复椎体高度，并且术后能较好维持椎体高度，骨水泥填充优良率较高，远期疗效较好

Clinical effect of percutaneous titanium mesh bone cement filling in treatment of senile patients with osteoporotic cone compression fractures

Objective　To explore the clinical effect of percutaneous titanium mesh bone cement filling in the treatment of senile patients with osteoporotic cone compression fractures. Methods　A total of 147 elderly patients with osteoporotic cone compression fractures admitted to Haiyang People's Hospital from January 2015 to December 2019 were retrospectively analyzed. The retrospective analysis of medical records was performed. Among them, 72 cases undergoing percutaneous titanium mesh bone cement filling were set as an observation group, including 34 males and 38 females, with an age of (70.5±10.6); the bone mineral density T value was –(3.04±0.04) SD; 22 cases had fractures on T12, 24 cases on L1, 16 cases on L2, 7 cases on L3, and 3 cases on L4. And the rest 75 cases who underwent curved vertebroplasty were set as a control group, including 36 males and 39 females, with an age of (71.5±9.6); the bone mineral density T value was –(3.07±0.09) SD; 20 cases had fractures on T12, 24 cases on L1, 15 cases on L2, 8 cases on L3, and 5 cases on L4. The operation times, bone cement injection volumes, numbers of fluoroscopy, scores of Visual Analogue Scale (VAS) and Oswestry disability indexes (ODI), and vertebral heights were recorded. The measurement data were compared between the two groups by independent-sample t test, and the enumeration data by χ² test. Results　There were no statistical differences in the operation time and number of fluoroscopy between the two groups (t=1.450, P=0.184; t=0.149, P=0.854). The bone cement injection volume in the observation group was significantly higher than that in the control group (6.37±0.55) ml vs. (3.73±0.27) ml, t= 37.169, P<0.001). There were no statistical differences in the scores of VAS and ODI before and 1 and 6 months after the operation between the two groups (all P>0.05). The scores of VAS and ODI at the last follow-up in the observation group were significantly better than those in the control group (t=3.822 and 5.373, both P<0.001). Before and 1 and 6 months after the operation, there were no statistical differences in the vertebral heights between the two groups (t=1.227, P=0.222; t=0.961, P=0.338; t=1.267, P=0.207). At the last follow-up, the vertebral height in the observation group was significantly better than that in the control group (t=14.812, P<0.001). Conclusions　Titanium mesh implantation vertebroplasty in the treatment of elderly osteoporotic cone compression fractures can better restore the height of the vertebral body. In addition, the height of the vertebral body can be better maintained after the operation, the excellent and good rate of bone cement filling is higher, and the long-term effect is better.