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椎体后凸成形术治疗椎体压缩骨折后注入骨水泥量与临床疗效分析

Analysis of injected cement volume and clinical outcomes following kyphoplasty for vertebral compression fractures.

作者信息

Self Mitchell, Mooney James, Amburgy John, Agee Bonita, Schoel Leah, Pritchard Patrick, Chambers Melissa

机构信息

Department of Neurosurgery, School of Medicine, The University of Alabama at Birmingham, United States.

Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, Alabama, United States.

出版信息

Surg Neurol Int. 2020 Mar 28;11:56. doi: 10.25259/SNI_22_2020. eCollection 2020.

Abstract

BACKGROUND

It has been suggested that greater volumes of cement injected during kyphoplasty correlate with improved vertebral body height restoration and kyphotic angulation correction. However, there is little evidence tying cement volume to patient outcomes. Here, we analyzed the association between cement volume and outcome utilizing indices of pain, disability, and quality of life.

METHODS

One hundred and thirty-six patients undergoing kyphoplasty were analyzed retrospectively. The total volume of bone cement injected was recorded intraoperatively for each patient; the average total cement volume was 5.44 cc. Pre- and postoperative outcome indices were documented, using the visual analog scale (VAS), Roland-Morris disability index (RMDI), and the EuroQol 5 Dimension instrument (EQ5D). Pearson's correlations and linear regression models were derived for the association of total cement volume with each of the patient outcome measures. This was a retrospective cohort study.

RESULTS

The average change in VAS, RMDI, and EQ5D scores for all patients was -6.8, +8.3, and +0.41, respectively. For VAS, RMDI, and EQ5D improvements, neither Pearson's correlations nor multiple linear regression models revealed a correlation or an association with total cement volume.

CONCLUSION

For patients undergoing kyphoplasty, outcomes were not associated with the total injected cement volume; all had a significant reduction in pain and most exhibited decreased disability with improved quality of life.

摘要

背景

有人提出,椎体后凸成形术中注入的骨水泥量越大,椎体高度恢复和后凸角矫正效果越好。然而,几乎没有证据表明骨水泥量与患者预后相关。在此,我们利用疼痛、残疾和生活质量指标分析了骨水泥量与预后之间的关联。

方法

回顾性分析136例行椎体后凸成形术的患者。术中记录每位患者注入的骨水泥总量;平均骨水泥总量为5.44立方厘米。使用视觉模拟量表(VAS)、罗兰-莫里斯残疾指数(RMDI)和欧洲五维健康量表(EQ5D)记录术前和术后的预后指标。推导骨水泥总量与各项患者预后指标之间的Pearson相关性和线性回归模型。这是一项回顾性队列研究。

结果

所有患者的VAS、RMDI和EQ5D评分的平均变化分别为-6.8、+8.3和+0.41。对于VAS、RMDI和EQ5D的改善情况,Pearson相关性分析和多元线性回归模型均未显示与骨水泥总量存在相关性或关联。

结论

对于行椎体后凸成形术的患者,预后与注入的骨水泥总量无关;所有患者的疼痛均显著减轻,大多数患者的残疾程度降低,生活质量提高。

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