骨水泥强化椎弓根螺钉技术治疗合并骨质疏松脊柱疾病的疗效观察

Cement-augmented pedicle screw technique for treatment of spinal diseases with osteoporosis

  • 摘要: 目的 探讨应用骨水泥强化椎弓根螺钉技术治疗多种合并骨质疏松脊柱疾病的临床效果。 方法 选取2013年5月-2016年8月在我科行脊柱后路手术的249例病例进行回顾,观察组(n=83)使用骨水泥椎弓根螺钉(cement-augmented pedicle screw,CPS)强化固定,对照组(n=166)使用传统椎弓根螺钉固定,记录患者基本资料、手术情况指标、手术前后的临床指标及影像学参数,并进行组间对比分析。 结果 两组病例年龄、性别、术前骨密度t值均无统计学差异(P均> 0.05)。观察组手术时间为(4.0±0.6) h,对照组为(3.1±0.8) h,观察组手术时间长于对照组(P=0.023),其余手术指标无统计学差异。手术效果评价方面,观察组与对照组在术前及术后3个月均无统计学差异,但在术后12个月,观察组的VAS评分、ODI评分均低于对照组(VAS:1.6±0.7 vs 2.4±0.5;ODI:21.0±5.3 vs 31.5±6.9,P均< 0.05)。在退行性侧凸与后凸畸形的影像学参数方面,观察组术后12个月的远期结果优于对照组(P< 0.05)。 结论 采用骨水泥螺钉治疗合并骨质疏松的多种脊柱退行性疾病安全有效,可以获得满意的远期效果。

     

    Abstract: Objective To investigate the clinical effect of cement-augmented pedicle screw (CPS) for the treatment of multiple spinal diseases with osteoporosis. Methods A total of 249 cases were selected from May 2013 to August 2016 for posterior spinal surgery in our department. Patients in observation group (n=83) underwent cemented pedicle screws (CPS) to strengthen fixation, while the control group (n=166) underwent traditional pedicle screw fixation. The basic information, indicators of surgery, clinical outcomes and radiological parameters were recorded before and after surgery, and comparative analysis was performed between the two groups. Results There was no statistical difference in age, gender and preoperative bone mineral density between the two groups (all P> 0.05). The operating time in observation group was significantly longer than that in control group(4.0 ± 0.6) h vs (3.1±0.6) h, P=0.023). There was no statistical difference in other surgical indexes. In terms of clinical results, there was no statistical difference between observation group and control group before and at 3 months after operation. However, at 12 months after operation, the VAS score and ODI score in the observation group were both lower than those in control groupVAS:(1.6±0.7) vs (2.4±0.5); ODI:(21.0±5.3) vs (31.5±6.9); P< 0.05, respectively). Long-term results of degenerative scoliosis and kyphosis measured by radiological parameters at 12 months after surgery were better in observation group than those in control group (all P< 0.05). Conclusion CPS is safe and effective for the treatment of multiple spinal degenerative diseases with osteoporosis, and it can achieve satisfactory long-term results.

     

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