骨质疏松性椎体骨折PVP术后骨水泥弥散分布与疼痛缓解情况的临床研究

doi:10.20223/j.cnki.1000-8535.2025.10.016

摘要/Abstract

摘要： 目的研究胸腰椎骨质疏松性椎体压缩性骨折（OVCF）经皮椎体成形术（PVP）后腰背部疼痛缓解情况与骨水泥弥散分布的相关性。方法选取2021年1月—2023年12月金沙县中医医院和毕节市第三人民医院185例因骨质疏松症导致的胸腰椎OVCF行PVP后的患者,根据术后胸腰椎正侧位X线片显示的骨水泥分布情况分为两组：骨水泥分布充分组（n=101例）和骨水泥分布不良组（n=84）,两组均行PVP,均行双侧穿刺入路。统计分析两组患者术前、术后及术后1周、3个月、6个月视觉模拟评分（VAS）、患者起床时间等情况。结果 185例患者术后随访半年,骨水泥分布充分组101例,骨水泥分布不良组84 例,两组术后VAS评分均较前缓解（P<0.05）,术后及术后1周、3个月、6个月的随访中分布充分组VAS评分分别为（7.17±0.76）（2.11±1.04）（1.4±0.78）（0.36±0.58）（0.05±0.22）分,优于分布不良组（7.14±0.79）（2.37±0.79）（1.89±0.82）（0.68±0.76）（0.25±0.62）分（P<0.05）。结论骨水泥的分布在一定程度上决定了PVP后患者腰背部残余痛的程度。尤其是骨水泥在椎体内均匀分布时,可降低术后腰背疼痛的发生率。

关键词: 椎体压缩骨折, 经皮椎体成形术, 骨水泥分布, 疼痛缓解情况

Abstract: Objective To study the relationship between pain relief situation in the lower back and bone cement distribution after percutaneous vertebroplasty（PVP）of thoracolumbar osteoporotic vertebral compression fracture（OVCF）．Methods A total of 185 patients with thoracolumbar OVCF caused by osteoporosis underwent PVP from January 2021 to December 2023 were selected in Jinsha County Hospital of Traditional Chinese Medicine and the Third People’s Hospital of Bijie City．Based on the distribution of bone cement shown in the anteroposterior and lateral X ray films of the thoracolumbar after the operation,they were divided into the group with adequate bone cement distribution（n=101 cases）and the group with poor bone cement distribution（n=84）．Both groups underwent PVP and bilateral puncture approaches．The Visual Analogue Scale（VAS）scores of the two groups of patients before the operation,after the operation,1 week,3 months,and 6 months after the operation,as well as the leaving bed time of the patients,were statistically analyzed．Results A total of 185 patients were followed up for half a year after the operation．There were 101 cases in the group with adequate bone cement distribution,and 84 cases in the poor distribution of bone cement group, There was no statistically significant difference in the preoperative general data between the two groups of patients（P>0.05）,and the postoperative VAS scores of both groups were decreased compared with those before operation（P<0.05）．The VAS scores of the adequate distributed group after the operation and in the follow-ups in 1 week,3 months,and 6 months after the operation were（7.17±0.76）,（2.11±1.04）,（1.4±0.78）,（0.36±0.58）,and（0.05±0.22）,respectively,better than the poor distribution group （7.14±0.79）,（2.37±0.79）,（1.89±0.82）,（0.68±0.76）,（0.25±0.62）,P<0.05．Conclusions The distribution of bone cement determines to a certain extent the degree of residual pain in the low back of patients after PVP．Especially when the bone cement is evenly distributed within the vertebral body,the incidence of postoperative low back pain can be reduced．

Key words: vertebral compression fracture, percutaneous vertebroplasty, bone cement distribution, pain relief situation

何顺, 陈邦灿, 叶雷, 申灿, 唐传茜, 蔡怀希. 骨质疏松性椎体骨折PVP术后骨水泥弥散分布与疼痛缓解情况的临床研究[J]. 广州医药, 2025, 56(10): 1428-1432.

HE Shun, CHEN Bangcan, YE Lei, SHEN Can, TANG Chuanxi, CAI Huaixi. Clinical study on the diffusion distribution of bone cement and pain relief after PVP for osteoporotic vertebral fractures[J]. Guangzhou Medical Journal, 2025, 56(10): 1428-1432.

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