摘要
目的研究经皮椎体后凸成形术后骨水泥渗漏与术后疼痛的关系。方法对2013年1月至2016年11月期间接受经皮椎体后凸成形术治疗且随访成功的120例胸腰椎骨折患者进行回顾性分析,根据患者的术后X线片显示骨水泥分布情况分为渗漏组(n=34)、非渗漏组(n=86),比较两组患者手术前后的VAS疼痛评分、Osw estry功能障碍指数(ODI)、椎体高度以及Cobb角。结果两组患者手术3 d后VAS评分均明显低于手术前(P<0.05);渗漏组手术后1、3个月的VAS评分与非渗漏组相比差异均无统计学意义(P>0.05);渗漏组手术后3 d的VAS评分明显高于非渗漏组(P<0.05);两组手术后3个月的ODI、椎体高度、Cobb角均明显改善(P<0.05),且两组相比差异无统计学意义(P>0.05);骨水泥渗漏与术后疼痛呈正相关(r=0.427,P<0.05),与术后ODI(r=0.152)、椎体高度(r=0.183)、Cobb角(r=0.145)均无线性相关。结论经皮椎体后凸成形术后骨水泥渗漏可能会加重术后近期疼痛程度,但对术后远期疼痛情况、疗效均无明显的影响。
Objective To evaluate association between postoperative pain and bone cement leakage in percutaneous kyphoplasty. Methods Clincal data of 120 patients with thoracolumbar fracture undergoing percutaneous kyphoplasty from January 2013 to November 2016 were retrospectively analyzed. Postoperative X ray examination showed that bone cement leakage occurred in 34 patients, did not occurred in 86 patients. The VAS pain score, Oswestry Disability Index （ODI） , vertebral height and Cobb angle were compared before and after operatiion and between two groups of patients. Results The postoperative VAS scores in both groups were significantly lower than those before operation （P 〈 0. 05）. The VAS score on 3 d after operation in leakage group was significantly higher than that of non-leakage group （P 〈 0. 05） ; however, there were no significant differences in VAS scores 1 and 3 months after surgery between two groups （ P 〉0.05）. Compared to those before surgery, the ODI, vertebral height and Cobb angle on 3 mongths after surgery in both groups were significantly improved （ P 〈 0. 05） , and there were no significant differences between two groups （ P 〉0. 05）. Bone cement leakage was positively correlated with postoperative pain （ r = 0. 427, P 〈 0. 0 5 ）; while it was not correlacted with postoperative vertebral height （ r = - 0.183, P 〉 0. 05）, Cobb angle （r = 0. 145, P 〉 0. 05） and ODI index （ r = 0. 152, P 〉 0. 05）. Conclusion Cement leakage after percutaneous kyphoplasty may aggravate the short-term postoperative pain, but has no significant effect on the long-term pain and curative effect.
出处
《同济大学学报（医学版）》
CAS
2017年第4期45-48,共4页
Journal of Tongji University(Medical Science)
作者简介
赵经缔（1991-）,男,博士研究生.E-mail：zhaojingweil616@163.com
通信作者：程黎明E-mail：clmd6821@163.com
