摘要
目的研究双侧高黏度骨水泥椎体成形术的临床治疗效果,并通过器械的发明创造,期望能够进一步降低双侧手术的治疗时间与治疗费用。方法选取2019年1月至2019年12月在我院骨科收治的50例骨质疏松性腰椎压缩骨折患者的资料进行回顾性分析;比较单侧组与双侧组患者在术后疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)、手术时间、骨水泥注射量、Cobb’s角及治疗费用上的差异。对双侧高黏度骨水泥注射系统进行改良。结果术后6个月两组患者的VAS评分、ODI、术后Cobb’s角等指标比较差异无统计学意义(P>0.05)。两组手术时间、骨水泥注射量、手术前后Cobb’s角改变情况、治疗费用比较差异有统计学意义(P<0.05)。两组患者均无感染、骨水泥渗漏、神经压迫甚至瘫痪等严重并发症发生。结论对于高黏度骨水泥椎体成形术,双侧手术与单侧手术均能取得良好的疗效,单侧手术时间更短,而双侧手术骨水泥注射量与手术前后Cobb’s角改变更多。相应的,由于双侧手术需要采取两套手术器械,患者的治疗费用要高于单侧组。为了降低双侧手术治疗费用,笔者发明设计了一种新型高黏度骨水泥椎体成形三通管道,实现利用一套注射器械进行双侧骨水泥注射的操作,后续将开展进一步的临床研究。
Objective To evaluate the clinical outcomes of bilateral high viscosity bone cement vertebroplasty,and improve the instruments to reduce the time and cost of bilateral surgery.Methods Clinical data of 50 patients with osteoporotic lumbar fracture were analyzed retrospectively from January 2019 to December 2019.Postoperative VAS,ODI,operation time,injection volume of bone cement,Cobb’s angle and cost were compared between the unilateral group and bilateral group.The bone cement injection system was updated.Results There were no statistically significant differences in VAS,ODI and Cobb’s angle between the two groups 6 months postoperatively(P>0.05),while significant differences were noted in operation time,injection volume,Cobb’s angle change and cost(P<0.05).No serious complications such as infection,cement leakage,nerve compression and paralysis occurred.Conclusions Both bilateral and unilateral viscosity bone cement vertebroplasty can achieve good efficacy.Unilateral operation takes less time,while bilateral group gets higher injection amount and larger Cobb’s angle change.Accordingly,the cost of unilateral vertebroplasty is higher because bilateral surgery requires two sets of instrument.In order to reduce the cost of bilateral surgical treatment,the author designs a new type of high viscosity bone cement vertebroplasty three-way pipe to reduce the cost.
作者
陈楷
戴小宇
崔海东
陈志刚
李立东
吕书军
CHEN Kai;DAI Xiao-yu;CUI Hai-dong;CHEN Zhi-gang;LI Li-dong;LYU Shu-jun(Department of Orthopedics,Hai'an People's Hospital,Hai'an,Jiangsu,226600,China)
出处
《中国骨与关节杂志》
CAS
2021年第10期771-776,共6页
Chinese Journal of Bone and Joint
基金
南通市卫生健康委员会科研课题立项(QB2019013)
南通市科技局立项(MSZ19024)。
关键词
腰椎
椎体成形术
骨水泥成形术
外科器械
Lumbar vertebrae
Vertebroplasty
Cementoplasty
Surgical instruments
