摘要
目的探讨经皮椎体成形术治疗脊柱转移瘤合并椎体骨折患者的临床疗效及影响因素。方法选取34例脊柱转移瘤合并椎体骨折患者,均接受经皮椎体成形术治疗。手术前、术后1周比较患者的椎体恢复情况,包括椎体前缘高度、矢状面Cobb角、椎体压缩率及椎体压缩改善率。手术前、术后6个月采用健康调查简表(SF-36)评估患者的生活质量,采用视觉模拟评分(VAS)评估患者的疼痛程度,采用Oswestry功能障碍指数(ODI)、罗兰-莫里斯残疾问卷(RMDQ)评估患者的功能障碍程度。术后椎体改善率的影响因素分析采用多元线性回归分析。结果术后1周,脊柱转移瘤合并椎体骨折患者的椎体前缘高度明显高于手术前,矢状面Cobb角明显小于手术前,椎体压缩率明显低于手术前,差异均有统计学意义(P﹤0.01)。多元线性回归分析结果显示,术前椎体压缩率及骨水泥弥散系数均是术后椎体压缩改善率的影响因素。术后6个月,脊柱转移瘤合并椎体骨折患者生理机能(PF)、躯体疼痛(BP)、一般健康状况(GH)、精力(VT)评分均明显高于手术前,VAS、ODI、RMDQ量表评分均明显低于手术前,差异均有统计学意义(P﹤0.01)。结论经皮椎体成形术可迅速、有效缓解脊柱转移瘤合并椎体骨折患者的临床症状,增加椎体前缘高度,改善椎体压缩率、疼痛程度和生活质量。术前椎体压缩率及骨水泥弥散系数是术后椎体压缩改善率的影响因素。
Objective To explore the clinical efficacy of percutaneous vertebroplasty in the treatment of spinal metastasis with vertebral fracture and the influencing factors.Method A total of 34 patients with spinal metastasis and vertebral fractures were treated with percutaneous vertebroplasty.Vertebral recovery was evaluated before and 1 week after operation,including anterior vertebral height,sagittal plane Cobb angle,vertebral compression rate and improvement rate of vertebral compression.The quality of life(QOL)of patients were assessed by the MOS 36 item short form health survey(SF-36)before and 6 months after operation,the degree of pain was assessed by visual analogue scale(VAS),and the degree of dysfunction was determined using Oswestry disability index(ODI)scale,and Roland-Morris disability questionnaire(RMDQ).The factors influencing the vertebral improvement rate were analyzed by multivariate linear regression analysis.Result One week after operation,the anterior height of vertebral body in patients with spinal metastasis and vertebral fracture was significantly higher than that before operation,and the sagittal plane Cobb angle was significantly smaller than before surgery,and vertebral compression rate was significantly lower compared with those before operation(P<0.01).Multivariate linear regression analysis showed that the preoperative vertebral compression rate and the dispersion coefficient of bone cement were the factors influencing the improvement rate of vertebral compression after operation.Six months after operation,physical functioning(PF),bodily pain(BP),general health(GH),and vitality(VT)scores of patients with spinal metastasis combined with vertebral fracture were significantly higher than those before operation,while VAS,ODI and RMDQ scores were evidently decreased compared with those before operation(P<0.01).Conclusion Percutaneous vertebroplasty can quickly and effectively alleviate the clinical symptoms of patients with spinal metastasis and vertebral fractures,increase the anterior height of the vertebral body,and improve the vertebral compression rate,with ameliorated degree of pain and QOL.Preoperative vertebral compression rate and dispersion coefficient of bone cement are the factors influencing the improvement rate of vertebral compression after operation.
作者
程根熙
杨火发
王瑞波
汪乾坤
CHENG Genxi;YANG Huofa;WANG Ruibo;WANG Qiankun(Department of Orthopaedics,Yingcheng People’s Hospital,Yingcheng 432400,Hubei,China)
出处
《癌症进展》
2019年第16期1920-1923,1959,共5页
Oncology Progress
关键词
脊柱转移瘤
椎体骨折
经皮椎体成形术
临床疗效
影响因素
spinal metastasis
vertebral fracture
percutaneous vertebroplasty
clinical efficacy
influencing factor
