北京生物医学工程

脊柱矢状位参数在骨质疏松性椎体压缩骨折治疗中的价值

Value of spinal sagittal parameters in the treatment of osteoporosis vertebral compression fractures

作者：韩晓斌王建光田明李玉民

单位：民航总医院骨科(北京 100123)<br />通信作者:王建光。E-mail: wangjianguang04272@ 163. com

关键词：骨质疏松症; 椎体压缩骨折; 脊柱矢状位参数; Cobb角

分类号：R318.1

出版年·卷·期（页码）：2021·40·4（413-417）

摘要：

目的探讨脊柱矢状位参数在骨质疏松性椎体压缩骨折(osteoporoticvertebralcompressionfractures , 0VCF)治疗中的价值。方法选取2016年1月至2019年9月民航总医院骨科收治的84例骨质疏松性椎体压缩骨折患者进行回顾性分析。将84例骨质疏松性椎体压缩骨折患者分为单次骨质疏松性椎体压缩骨折组和多次骨质疏松性椎体压缩骨折组，术前均行X线、MRI/骨扫描检查，进行视觉模拟评分( visual analogue scale, VAS)，并测量脊柱Cobb角以及C7铅垂线与骨折椎体的距离( the distancebetween the C7 plumb line and the fracture vertebra, DSVA)。两组患者均行经皮穿刺椎体成形术治疗。结果单次骨质疏松性椎体压缩骨折组术前和术后VAS比较.差异具有统计学意义(P<0.05)。多次骨质疏松性椎体压缩骨折组术前和术后VAS比较,差异具有统计学意义(P<0.05)。单次和多次骨质疏松性椎体压缩骨折组术前VAS比较,差异无统计学意义(P>0.05)。单次和多次骨质疏松性椎体压缩骨折组术后VAS比较，差异无统计学意义(P>0.05)。单次和多次骨质疏松性椎体压缩骨折组脊柱Cobb角比较，差异有统计学意义(P<0.05)。单次和多次骨质疏松性椎体压缩骨折组的DSVA比较,差异有统计学意义(P<0.05)。结论脊柱矢状位参数Cobb角和DSVA对骨质疏松性椎体压缩骨折临床治疗的生物力学稳定性具有重要意义,可为取得最佳临床效果提供重要的参考价值。

Objective To discuss the value of spinal sagittl parameters in the treatment of osteoporosisvertebral compression fractures. Methods Eighty-four patients with vertebral compression fractures admitted tothe department of orthopedics in Civil Aviation General Hospital from January 2016 to September 2019 wereselected for retrospective analysis. These cases of vertebral compression fractures were divided into two groupsincluding the one of single vertebral compression fractures and the other of multiple vertebral compression fractures. Preoperative X-ray and MRL/ radionuclide bonescan examinations were performed for visual analogue scale/ score( VAS) , through which both the Cobb angle of the spine and the distance between the C7 plumb line and the fracture vertebra ( DSVA ) were measured.Moreover , percutaneous vertebroplasty was carried out in both groups. Results Scores of VAS before and afterthe single vertebral compression fracture operations were compared, and the difference was statisticallysignificant ( P<0. 05). Similarly , the difference between scores of VAS before and after operations of multiplevertebral compression fractures were also statistically significant ( P<0.05 ). However , there was no statisticallysignificant difference between scores of VAS before single vertebral compression fracture operations and thosebefore operations of multiple vertebral compression fractures (P>0. 05). The same was true for the differencebetween scores of VAS after single vertebral compression fracture operations and those after operations ofmultiple vertebral compression fractures ( P> 0.05). Furthermore , there was statistically significant differencebetween Cobb angles of the spine with single vertebral compression fracture and that with multiple vertebralcompression fractures ( P< 0.05). The comparison of single vertebral compression fracture and multiplevertebral compression fractures by DSVA was statistically significant( P<0.05 ). Conclusions The sagittal spinalparameters Cobb angle and DSVA have great influence on the biomechanical stability of the clinical treatment ofosteoporotic vertebral compression fractures, which can be used as important references to achieve the bestclinical effects.

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