CAJ | 학술논문

背景：在应用高黏度骨水泥以及椎体成形修复骨质疏松性椎体压缩骨折的过程中，骨水泥的推注量-压缩椎体高度的恢复-临床疗效”之间是否存在必然联系以及内在的规律，目前缺乏此方面的循证医学证据，且存在一定争议。 　　目的：观察经皮椎体成形高黏度骨水泥注入修复老年骨质疏松椎体压缩性骨折的椎体高度恢复情况。 　　方法：选取2011年1月至2012年12月新疆维吾尔自治区中医医院脊柱外科收治的骨质疏松压缩性骨折老年患者110例，共139椎，均由同一组外科医生采用经皮椎体成形治疗，在骨水泥拉丝期时在“G”形臂监视下将高黏度骨水泥注入骨折椎体内。治疗后随访12个月，以目测类比评分、Barthel指数、椎体高度恢复为观察评价指标。 　　结果与结论：110例患者共139椎，修复过程顺利，单个椎体骨水泥平均注入量为3-6 mL，平均3.5 mL。患者的目测类比评分由治疗前平均7.9分降到了治疗后12个月的平均1.8分；Barthel 指数治疗前平均为40.25，治疗后12个月时为82.21，治疗后与治疗前比较目测类比评分和Barthel指数均有明显改善(P <0.05)。治疗后139个椎体前、中部的高度增加到了原椎体高度的(81.25±9.26)%和(78.22±10.65)%，治疗后24 h、3个月、12个月与治疗前相比椎体前部、中部高度均有显著恢复(P <0.05)。治疗后通过随访观察发现，发生高黏度骨水泥渗漏的椎体有5个，以上患者未出现临床症状，未发生神经损伤或肺栓塞等严重并发症。提示经皮椎体成形高黏度骨水泥注入修复骨质疏松性椎体压缩性骨折的过程中，不仅可以有效缓解患者疼痛，在不同程度上恢复压缩椎体的高度，而且并发症发生率低，患者恢复时间短。
배경：재응용고점도골수니이급추체성형수복골질소송성추체압축골절적과정중，골수니적추주량-압축추체고도적회복-림상료효”지간시부존재필연련계이급내재적규률，목전결핍차방면적순증의학증거，차존재일정쟁의。 　　목적：관찰경피추체성형고점도골수니주입수복노년골질소송추체압축성골절적추체고도회복정황。 　　방법：선취2011년1월지2012년12월신강유오이자치구중의의원척주외과수치적골질소송압축성골절노년환자110례，공139추，균유동일조외과의생채용경피추체성형치료，재골수니랍사기시재“G”형비감시하장고점도골수니주입골절추체내。치료후수방12개월，이목측류비평분、Barthel지수、추체고도회복위관찰평개지표。 　　결과여결론：110례환자공139추，수복과정순리，단개추체골수니평균주입량위3-6 mL，평균3.5 mL。환자적목측류비평분유치료전평균7.9분강도료치료후12개월적평균1.8분；Barthel 지수치료전평균위40.25，치료후12개월시위82.21，치료후여치료전비교목측류비평분화Barthel지수균유명현개선(P <0.05)。치료후139개추체전、중부적고도증가도료원추체고도적(81.25±9.26)%화(78.22±10.65)%，치료후24 h、3개월、12개월여치료전상비추체전부、중부고도균유현저회복(P <0.05)。치료후통과수방관찰발현，발생고점도골수니삼루적추체유5개，이상환자미출현림상증상，미발생신경손상혹폐전새등엄중병발증。제시경피추체성형고점도골수니주입수복골질소송성추체압축성골절적과정중，불부가이유효완해환자동통，재불동정도상회복압축추체적고도，이차병발증발생솔저，환자회복시간단。
BACKGROUND:Whether there is a necessary connection or internal patterns between the amount of bone cement-recovery of vertebral height-clinical efficacy has no evidence-based medicine findings in the treatment of osteoporotic vertebral compression fractures using percutaneous vertebroplasty with high-viscosity bone cement injection. OBJECTIVE: To observe the change of vertebral height in the elderly with osteoporotic vertebral compression fractures after percutaneous vertebroplasty with high-viscosity bone cement injection. METHODS:A total of 110 elderly patients with osteoporotic vertebral compression fractures (139 vertebrae) were admitted at the Traditional Chinese Medical Hospital of Xinjiang Uygur Autonomous Region from January 2011 to December 2012. Al the patients received percutaneous vertebroplasty by the same group of surgeons. Bone cement at drawing stage was injected into the fractured vertebra. During the 12-month folow-up, visual analogue scale, Barthel index and vertebral height restoration were observed as evaluation indexes. RESULTS AND CONCLUSION:The surgical treatment was done successfuly in the 110 patients (139 vertebrae). The amount of bone cement per vertebra was 3-6 mL, with a mean of 3.5 mL. At 12 months after surgery, the visual analog scale scores were decreased from 7.9 to 1.8, Barthel index was increased from 40.25 to 82.21, both of which were improved significantly (P < 0.05). After surgery, the vertebral heights at the anterior and middle parts were increased by (81.25±9.26)% and (78.22±10.65)%, respectively, and there was significant differences before ant at 24 hours, 3 months and 12 months after surgery (P < 0.05). During the folow-up, there were five vertebrae with bone cement leakage, but no clinical symptoms occurred, and no nerve injury or pulmonary embolism happened. These findings indicate that percutaneous vertebroplasty with high-viscosity bone cement injection can effectively relieve pain, restore the vertebral height, reduce the incidence of complications and shorten the recovery time in patients with osteoporotic vertebral compression fractures.