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椎体强化术后残留痛与骨水泥弥散分布的相关性分析:一项回顾性队列研究。

Correlation Analysis between Residual Pain after Vertebral Augmentation and the Diffusion Distribution of Bone Cement: A Retrospective Cohort Study.

机构信息

The First Clinical Medical School, Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, China.

Shandong University of Traditional Chinese Medicine, Jinan, Shandong 250014, China.

出版信息

Pain Res Manag. 2023 Jan 4;2023:1157611. doi: 10.1155/2023/1157611. eCollection 2023.

Abstract

OBJECTIVE

To explore the influence and potential factors of the bone cement dispersion state on residual pain after vertebral augmentation.

METHODS

The cases included in this retrospective cohort study were patients treated with vertebral augmentation (VA) for osteoporotic vertebral compression fractures (OVCFs) between July 2018 and June 2021. According to the type of cement diffusion distribution, the patients were divided into a sufficient diffusion group (Group A) and an insufficient diffusion group (Group B). The differences in the baseline data, visual analog scale (VAS), Oswestry disability index score (ODI), injured vertebral height (IVH), and local kyphosis angle (LKA) between the two groups were analyzed. Assessments were performed preoperatively on the 2nd day postoperation and at the last follow-up. The imaging data of injured vertebrae were accurately reconstructed by a GE AW4.7 workstation, and the differences in the vertebral body volume, bone cement volume, and bone cement volume ratio were compared between the groups.

RESULT

After screening, 36 patients were included. (1) The postoperative VAS and ODI scores of the two groups were significantly improved compared with the preoperative scores. (2) On the 2nd day postoperation and the last follow-up, the VAS and ODI scores of Group A were significantly different from those of Group B, and Group A outperformed Group B. (3) The IVH and LKA of the two groups were improved after the operation, and no significant difference was found between the groups. (4) Significant differences were found in the bone cement volume and bone cement volume ratio between the groups, and Group A was larger than Group B.

CONCLUSIONS

Sufficient bone cement diffusion can reduce residual pain after vertebral augmentation.

摘要

目的

探讨骨水泥弥散状态对椎体强化术后残留痛的影响及潜在因素。

方法

本回顾性队列研究纳入 2018 年 7 月至 2021 年 6 月接受椎体强化术(vertebral augmentation,VA)治疗的骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCFs)患者。根据骨水泥弥散分布类型,将患者分为弥散充分组(A 组)和弥散不充分组(B 组)。比较两组患者的基线资料、视觉模拟评分(visual analog scale,VAS)、Oswestry 功能障碍指数(Oswestry disability index score,ODI)评分、伤椎高度(injury vertebral height,IVH)和局部后凸角(local kyphosis angle,LKA)。分别于术前、术后第 2 天及末次随访时进行评估。采用 GE AW4.7 工作站对伤椎进行准确的影像学重建,比较两组患者椎体体积、骨水泥体积及骨水泥体积比的差异。

结果

筛选后共纳入 36 例患者。(1)两组患者术后 VAS 和 ODI 评分均较术前明显改善。(2)术后第 2 天及末次随访时,A 组 VAS 和 ODI 评分均明显优于 B 组,A 组优于 B 组。(3)两组患者术后 IVH 和 LKA 均较术前改善,两组间差异无统计学意义。(4)两组患者骨水泥体积及骨水泥体积比比较差异有统计学意义,A 组大于 B 组。

结论

骨水泥弥散充分可减轻椎体强化术后残留痛。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9dab/9833933/d6f81643d24e/PRM2023-1157611.001.jpg

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