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1.雅安市人民医院骨科,四川 雅安 625000
2.雅安市人民医院中西医科,四川 雅安 625000
杨滔,E-mail:gm265q@163.com
收稿日期:2024-11-01,
纸质出版日期:2025-09-25
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杨滔,肖军,张艳秋.IPKP治疗胸腰椎OVCF的效果及术后骨水泥渗漏的危险因素分析[J].局解手术学杂志,2025,34(09):805-808.
YANG Tao,XIAO Jun,ZHANG Yan-qiu.Effect of IPKP in the treatment of thoracolumbar OVCF and analysis of risk factors for postoperative bone cement leakage[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):805-808.
杨滔,肖军,张艳秋.IPKP治疗胸腰椎OVCF的效果及术后骨水泥渗漏的危险因素分析[J].局解手术学杂志,2025,34(09):805-808. DOI: 10.11659/jjssx.11E024006.
YANG Tao,XIAO Jun,ZHANG Yan-qiu.Effect of IPKP in the treatment of thoracolumbar OVCF and analysis of risk factors for postoperative bone cement leakage[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2025,34(09):805-808. DOI: 10.11659/jjssx.11E024006.
目的
2
探讨改良经皮球囊扩张椎体后凸成形术(IPKP)治疗胸腰椎骨质疏松性椎体压缩骨折(OVCF)的效果,并分析术后骨水泥渗漏的危险因素。
方法
2
纳入2020年3月至2022年3月我院收治的115例胸腰椎OVCF患者,按照手术方法的不同分为IPKP组(
n
=64)和经皮球囊扩张椎体后凸成形术(PKP)组(
n
=51)。记录患者手术相关情况及术后并发症情况;比较患者术前及术后3个月、1年视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)评分、椎体前缘高度、椎体中部高度和Cobb角。分析术后骨水泥渗漏的影响因素。
结果
2
IPKP组患者手术时间长于PKP组(
P
<
0.05),术中骨水泥注入量组间比较差异无统计学意义(
P
>
0.05)。术后3个月、1年,IPKP组和PKP组患者VAS、ODI评分与术前比较均降低(
P
<
0.05),但术后VAS、ODI评分组间比较差异均无统计学意义(
P>
0.05)。术后3个月、1年,IPKP组和PKP组患者椎体前缘、中部高度与术前比较均增加(
P
<
0.05),Cobb角均减小(
P
<
0.05);术后1年IPKP组患者椎体前缘、中部高度均明显大于PKP组(
P
<
0.05),Cobb角明显小于PKP组(
P
<
0.05)。115例胸腰椎OVCF患者术后未出现感染、再骨折、血管栓塞等并发症,术后出现骨水泥渗漏13例,而终板/后壁不完整是其危险因素(
P
<
0.05)。
结论
2
与PKP相比,IPKP治疗胸腰椎OVCF效果更好,椎体结构恢复更佳。终板/后壁不完整会增加术后骨水泥渗漏的风险,需采取合理有效的干预措施。
Objective
2
To explore the outcome of improved percutaneous kyphoplasty (IPKP) for the treatment of thoracolumbar osteoporotic vertebral compression fracture (OVCF),and analyze the risk factors of postoperative bone cement leakage.
Methods
2
A total of 115 patients with thoracolumbar OVCF admitted to our hospital from March 2020 to March 2022 were included and divided into the IPKP group (
n
=64) and the percutaneous kyphoplas
ty (PKP) group (
n
=51) according to different surgical methods. The surgery related condition and postoperative complications of patients were recorded. The visual analogue scale (VAS) scores,Oswestry disability index (ODI) scores,anterior vertebral height,middle vertebral height and Cobb angle of patients before surgery and 3 months and 1 year after surgery were compared. The influencing factors of postoperative bone cement leakage were analyzed.
Results
2
The operation time of patients in the IPKP group was longer than that in the PKP group (
P
<
0.05),while there was no statistically significant difference in the injected amount of bone cement during the operation between the two groups (
P
>
0.05). The VAS and ODI scores of patients in the two groups decreased 3 months and 1 year after surgery compared with those before surgery (
P
<
0.05),while there was no statistically significant difference in VAS or ODI scores after surgery between the two groups (
P
>
0.05). Three months and 1 year after surgery the anterior and middle vertebral heights of patients in the IPKP and PKP groups increased and the Cobb angle decreased compared with those before surgery (
P
<
0.05). One year after surgery,the anterior and middle vertebral heights in the IPKP group were significantly higher than those in the PKP group (
P
<
0.05),and the Cobb angle was significantly smaller than that in the PKP group (
P
<
0.05). Among the 115 patients with thoracolumbar OVCF,there was no complications such as infection,re-fracture,or vascular embolism occurred after surgery,and there were 13 cases with bone cement leakage,whose risk factor was incomplete endplate/posterior wall (
P
<
0.05).
Conclusion
2
Compared with PKP,IPKP in the treatment of thoracolumbar OVCF has better effect and better recovery of vertebral structure. Incomplete endplate/posterior wall can increase the risk of postoperative bone cement leakage,which requires reasonable and effective intervention measures.
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