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一项为期 3 年的研究比较经皮椎体成形术与保守治疗治疗单节段胸腰椎骨质疏松性压缩骨折的疗效。

Comparison of percutaneous vertebroplasty and conservative treatment for one level thoracolumbar osteoporotic compression fracture in a 3-year study.

机构信息

Department of Spine, General Hospital of Northern Theater Command, 83 Wenhua Rd, Shen He Qu, Shenyang, 110017, Liaoning, China.

出版信息

Sci Rep. 2023 Nov 20;13(1):20264. doi: 10.1038/s41598-023-36905-8.

Abstract

The efficacy of Mesh optimized versus standard percutaneous vertebroplasty (PVP) for osteoporotic vertebral compression fractures. Grid optimization (102 cases; 38 men, 64 women aged 67.3 ± 8.5) and traditional PVP groups (94 cases) were identified from 196 PVP patients treated from May 2016 to 2019. The optimal puncture site and angle forced bone cement into both groups before surgery. The main indexes were operation time, X-ray fluoroscopy times, bone cement injection volume, leakage, VAS, and injured vertebrae height. Preoperative general data were equivalent between groups (P > 0.05). All patients survived surgery without spinal cord injury, incision infection, pulmonary embolism, or death. The mesh optimization group had improved operation time (34.8 ± 6.5 min), fluoroscopy times (29.5 ± 5.5), bone cement injection volume (5.3 ± 2.1 ml), and bone cement permeability greater (3.9 percent; 4/98) than the standard PVP group (P < 0.05). Similarly, the grid optimization group had superior VAS scores (1.1 ± 0.6; 1.0 ± 0.3; and 0.9 ± 0.2) than the standard PVP group at 3 days, 3 months, and the last follow-up visit (P < 0.05). On day three after surgery, both had similar heights of injured vertebra's anterior and middle edges (P > 0.05). However, in the mesh optimization group, measurements improved to 1.8 ± 0.4 mm and (1.8 ± 0.3) mm by month three and to 1.7 ± 0.3 mm at last follow-up (P < 0.05). Mesh-optimized PVP with a mesh locator treats osteoporotic vertebral compression fractures more safely and effectively than regular PVP.

摘要

网格优化与标准经皮椎体后凸成形术(PVP)治疗骨质疏松性椎体压缩性骨折的疗效比较。从 2016 年 5 月至 2019 年治疗的 196 例 PVP 患者中,确定了网格优化组(102 例;38 例男性,64 例女性,年龄 67.3±8.5 岁)和传统 PVP 组(94 例)。两组患者术前均采用最优穿刺点和角度强迫骨水泥进入病变椎体。主要指标包括手术时间、X 线透视次数、骨水泥注射量、渗漏、VAS 评分和伤椎高度。两组患者术前一般资料比较差异无统计学意义(P>0.05)。所有患者均顺利完成手术,无脊髓损伤、切口感染、肺栓塞或死亡。网格优化组手术时间(34.8±6.5 min)、透视次数(29.5±5.5 次)、骨水泥注射量(5.3±2.1 ml)、骨水泥渗漏率(3.9%,4/98)均优于标准 PVP 组(P<0.05)。同样,网格优化组在术后 3 天、3 个月和末次随访时 VAS 评分(1.1±0.6、1.0±0.3、0.9±0.2)均优于标准 PVP 组(P<0.05)。术后 3 天两组伤椎前缘及中部高度比较差异无统计学意义(P>0.05)。但在网格优化组,伤椎前缘及中部高度分别于术后 3 个月改善至 1.8±0.4mm 和(1.8±0.3)mm,末次随访时改善至 1.7±0.3mm(P<0.05)。网格定位器辅助网格优化 PVP 治疗骨质疏松性椎体压缩性骨折更安全、有效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e4ed/10661551/20e1d008c853/41598_2023_36905_Fig1_HTML.jpg

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