骨质疏松性椎体压缩性骨折患者椎体内骨水泥分布与经皮穿刺椎体成形术后疼痛程度的相关性研究
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青海省重点研发计划项目(2023-wjzdx-08);


Correlation between distribution of bone cement in vertebral body and pain degree in patients with osteoporotic vertebral compression fracture after percutaneous vertebroplasty
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    摘要:

    目的:探讨骨质疏松性椎体压缩性骨折(OVCF)患者椎体内骨水泥分布与经皮穿刺椎体成形(PVP)术后疼痛程度的相关性。方法:回顾性分析行PVP术治疗的150例OVCF患者临床资料,根据骨水泥分布指数(DI),分为骨水泥充分弥散组(n=96)和骨水泥弥散不足组(n=54),比较两组患者疼痛视觉模拟评分(VAS)、椎体前缘高度、椎体后凸Cobb角、骨密度及术后并发症总发生率。通过有序Logistic回归分析骨水泥DI与VAS、椎体前缘高度、椎体后凸Cobb角、骨密度及术后并发症总发生率的相关性。结果:两组患者术后1、3个月VAS评分均低于术后1周(P<0.05),且骨水泥充分弥散组患者各时间点VAS评分均低于弥散不足组(P<0.05);术后1、3个月,两组患者椎体前缘高度比较术后1周时均上升(P<0.05);术后1、3个月,骨水泥弥散不足组后凸Cobb角较术后1周时降低(P<0.05),而骨水泥充分弥散组后凸Cobb角无差异(P>0.05)。骨水泥充分弥散组术后各时间点椎体前缘高度比、后凸Cobb角均低于骨水泥弥散不足组(P<0.05);与术后1周时相比,两组患者术后1、3个月骨密度均上升(P<0.05),且骨水泥充分弥散组术后1、3个月点骨密度均高于骨水泥弥散不足组(P<0.05);骨水泥充分弥散组患者术后并发症总发生率低于骨水泥弥散不足组(P<0.05);相关性分析显示,骨水泥DI与VAS评分、后凸Cobb角、骨密度、术后并发症总发生率负相关;与椎体前缘高度正相关(P<0.05)。结论:椎体内骨水泥分布与PVP术后疼痛程度、椎体功能恢复密切相关。

    Abstract:

    Objective:To investigate the correlation between distribution of bone cement in vertebral body and degree of pain after percutaneous vertebroplasty(PVP)in patients with osteoporotic vertebral compression fracture(OVCF).Methods:The clinical data of 150 patients with OVCF who received PVP were retrospectively analyzed.According to the bone cement distribution index(DI),they were divided into bone cement full dispersion group(n=96)and bone cement insufficient disper-sion group(n=54).The visual analogue scale(VAS),anterior vertebral height,kyphosis Cobb angle,bone mineral density and total incidence rate of postoperative complications were compared between the two groups of patients.Ordered Logistic regres-sion was used to analyze the correlation between bone cement DI and VAS,anterior vertebral height,kyphosis Cobb angle,bone mineral density and total incidence rate of postoperative complications.Results:The VAS score at 1 and 3 months after surgery in the two groups of patients was lower than that at 1 week after surgery(P<0.05),and the VAS score at each time point in bone cement full dispersion group was lower than that in bone cement insufficient dispersion group(P<0.05).The anterior vertebral height ratio in both groups of patients was enhanced at 1 and 3 months after surgery compared to 1 week after surgery(P<0.05).At 1 and 3 months after surgery,the kyphosis Cobb angle in bone cement insufficient dispersion group was reduced compared with that at 1 week after surgery(P<0.05),and there was no difference in the kyphosis Cobb angle in bone cement full dispersion group(P>0.05).The anterior vertebral height ratio and kyphosis Cobb angle at each time point after surgery in bone cement fill dispersion group were lower than those in bone cement insufficient dispersion group(P<0.05).Compared with 1 week after surgery,the bone mineral density in the two groups of patients was increased at 1 month and 3 months after surgery(P<0.05),and the bone mineral density in bone cement full dispersion group was higher than that in bone cement in-sufficient dispersion group at 1 month and 3 months after surgery(P<0.05).The total incidence rate of postoperative compli-cations in bone cement full dispersion group was lower than that in bone cement insufficient dispersion group(P<0.05).Cor-relation analysis showed that bone cement DI was negatively correlated with VAS score,kyphosis Cobb angle,bone mineral den-sity and total incidence rate of postoperative complications,and was positively correlated with anterior vertebral height(P<0.05).Conclusion:The distribution of bone cement in vertebral body is closely related to the degree of pain and recovery of ver-tebral function after PVP.

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马骏;严文琪;巩栋;韩生寿;.骨质疏松性椎体压缩性骨折患者椎体内骨水泥分布与经皮穿刺椎体成形术后疼痛程度的相关性研究[J].川北医学院学报,2025,40(10):1239-1243.

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  • 在线发布日期: 2025-11-03
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