椎体成形术中明胶海绵填塞治疗椎体前壁破损的OVCFs的临床疗效观察(1)
摘要：目的 分析椎體成形术(PVP)中明胶海绵填塞治疗椎体前壁破损的胸腰椎骨质疏松性骨折(OVCFs)的临床疗效。方法 通过回顾性分析我科2016年1月～2018年10月采用PVP手术治疗老年性OVCFs椎体前壁破裂80例，根据手术方法不同分为明胶绵组和对照组，各40例。明胶体海绵组PVP手术中对椎体前壁破损者联合明胶海绵填塞，对照组行常规PVP手术治疗椎体前壁破损患者。比较两组患者手术时间、单个椎体骨水泥注入量、椎体数、手术前后VAS 评分、ODI指数、椎体前缘高度、Cobb角以及骨水泥前方渗漏率。结果 80例患者均顺利完成手术。两组患者手术时间、单个椎体骨水泥注入量以及椎体数比较，差异无统计学意义(P>0.05);两组患者VAS评分、ODI指数、椎体前缘高度和Cobb角手术后比较，差异无统计学意义(P>0.05);明胶海绵组术后3 d VAS评分和ODI指数均低于术前[(2.68±1.34)分 vs (7.08±0.61)分，(20.91±6.09)vs(74.59±6.46)]，对照组术后3 d VAS评分和ODI指数均低于术前[(2.73±1.28)分 vs (6.81±0.87)分，(21.95±5.20)vs(75.96±5.12)]，差异有统计学意义(P<0.05)。明胶海绵组术后椎体前缘高度大于术前[(22.09±2.41)mm vs (18.05±2.74)mm]，Cobb角小于术前[(11.01±2.42)° vs (20.80±5.23)°]，对照组术后椎体前缘高度大于术前[(21.81±2.31)mm vs (18.36±2.67)mm]，Cobb角小于术前[(12.74±3.06)° vs (22.41±4.48)°]，差异有统计学意义(P<0.05)。明胶海绵组骨水泥前方渗漏率低于对照组(5.00% vs 25.00%)，差异有统计学意义(P<0.05)。结论 对于椎体前壁破裂者椎体成形术中是否使用明胶海绵填塞与其临床疗效无明显差异，但可有效降低椎体前方骨水泥的渗漏。
, 百拇医药
关键词：明胶海绵填塞;椎体压缩性骨折;椎体成形;骨质疏松
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.11.023
文章编号：1006-1959(2019)11-0085-05
Abstract：Objective To analyze the clinical efficacy of gelatin sponge in the treatment of thoracolumbar osteoporotic fractures (OVCFs) in vertebral body anterior wall fracture in vertebroplasty (PVP). Methods Through retrospective analysis， 80 patients with anterior wall rupture of senile OVCFs were treated with PVP surgery from January 2016 to October 2018. According to different surgical methods， they were divided into gelatin cotton group and control group， 40 cases each. In the PVP operation of gelatin sponge group， the anterior wall of the vertebral body was damaged with gelatin sponge， and the control group was treated with conventional PVP for the treatment of anterior wall injury of the vertebral body. The operation time， single vertebral bone cement injection volume， vertebral body number， VAS score before and after surgery， ODI index， vertebral body leading edge height， Cobb angle and bone cement leakage rate were compared between the two groups.Results 80 patients successfully completed the operation. There was no significant difference in the operation time， single vertebral bone cement injection volume and vertebral body number between the two groups (P>0.05). The VAS score， ODI index， vertebral body height and Cobb angle were compared between the two groups，the difference was not statistically significant (P>0.05). The 3d VAS score and ODI index of the gelatin sponge group were lower than those before operation [(2.68±1.34) points vs (7.08±0.61) points， (20.91±6.09) vs (74.59±6.46)]， and the control group 3 d VAS score and ODI index were lower than preoperative [(2.73±1.28) points vs (6.81±0.87) points， (21.95±5.20) vs (75.96±5.12)]， the difference was statistically significant (P<0.05). The height of the anterior border of the vertebral body in the gelatin sponge group was greater than that before surgery [(22.09±2.41) mm vs (18.05±2.74) mm]， and the Cobb angle was smaller than that before surgery [(11.01±2.42)° vs (20.80±5.23)°]. In the control group， the height of the anterior border of the vertebral body was greater than that before surgery [(21.81±2.31) mm vs (18.36±2.67) mm]， and the Cobb angle was smaller than that before surgery [(12.74±3.06)° vs (22.41±4.48)°]，the difference was statistically significant (P<0.05). The leakage rate of bone cement in the gelatin sponge group was lower than that in the control group (5.00% vs 25.00%)，the difference was statistically significant (P<0.05).Conclusion There is no significant difference between the use of gelatin sponge in vertebroplasty for vertebral body anterior wall rupture and its clinical efficacy， but it can effectively reduce the leakage of bone cement in front of the vertebral body., 百拇医药(张强 杨帆 陈康)
, 百拇医药
关键词：明胶海绵填塞;椎体压缩性骨折;椎体成形;骨质疏松
中图分类号：R687.3 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.11.023
文章编号：1006-1959(2019)11-0085-05
Abstract：Objective To analyze the clinical efficacy of gelatin sponge in the treatment of thoracolumbar osteoporotic fractures (OVCFs) in vertebral body anterior wall fracture in vertebroplasty (PVP). Methods Through retrospective analysis， 80 patients with anterior wall rupture of senile OVCFs were treated with PVP surgery from January 2016 to October 2018. According to different surgical methods， they were divided into gelatin cotton group and control group， 40 cases each. In the PVP operation of gelatin sponge group， the anterior wall of the vertebral body was damaged with gelatin sponge， and the control group was treated with conventional PVP for the treatment of anterior wall injury of the vertebral body. The operation time， single vertebral bone cement injection volume， vertebral body number， VAS score before and after surgery， ODI index， vertebral body leading edge height， Cobb angle and bone cement leakage rate were compared between the two groups.Results 80 patients successfully completed the operation. There was no significant difference in the operation time， single vertebral bone cement injection volume and vertebral body number between the two groups (P>0.05). The VAS score， ODI index， vertebral body height and Cobb angle were compared between the two groups，the difference was not statistically significant (P>0.05). The 3d VAS score and ODI index of the gelatin sponge group were lower than those before operation [(2.68±1.34) points vs (7.08±0.61) points， (20.91±6.09) vs (74.59±6.46)]， and the control group 3 d VAS score and ODI index were lower than preoperative [(2.73±1.28) points vs (6.81±0.87) points， (21.95±5.20) vs (75.96±5.12)]， the difference was statistically significant (P<0.05). The height of the anterior border of the vertebral body in the gelatin sponge group was greater than that before surgery [(22.09±2.41) mm vs (18.05±2.74) mm]， and the Cobb angle was smaller than that before surgery [(11.01±2.42)° vs (20.80±5.23)°]. In the control group， the height of the anterior border of the vertebral body was greater than that before surgery [(21.81±2.31) mm vs (18.36±2.67) mm]， and the Cobb angle was smaller than that before surgery [(12.74±3.06)° vs (22.41±4.48)°]，the difference was statistically significant (P<0.05). The leakage rate of bone cement in the gelatin sponge group was lower than that in the control group (5.00% vs 25.00%)，the difference was statistically significant (P<0.05).Conclusion There is no significant difference between the use of gelatin sponge in vertebroplasty for vertebral body anterior wall rupture and its clinical efficacy， but it can effectively reduce the leakage of bone cement in front of the vertebral body., 百拇医药(张强 杨帆 陈康)