| Background:Osteoporosis has become an important health problem for middle-aged and elderly people in my country.One of its most common complications is osteoporotic vertebral compression fractures(OVCFs),and percutaneous vertebroplasty is a treatment for vertebral bodies.An effective means of compression fractures.It can quickly relieve pain and promote early recovery.However,there are still some OVCFs patients who undergo vertebroplasty treatment and have adverse events such as poor pain relief and strengthened vertebral body recollapse.The success rate of vertebroplasty in the treatment of OVCF is 89%～93%,indicating that vertebroplasty There is still room for optimization of clinical efficacy.This article intends to collect the preoperative and postoperative data of patients who have undergone percutaneous vertebroplasty in our hospital in recent years,and compare the traditional vertebroplasty with the targeted puncture catheter combined with side-port push rod technology in the treatment of bone.The clinical effect of OVCFs is different,and the effectiveness and safety of vertebroplasty with targeted puncture catheterization combined with side-port push rod technology in clinical application are discussed.Objective:To compare the clinical effects of traditional vertebroplasty and targeted puncture catheterization combined with side-port push rod technology in the treatment of osteoporotic vertebral compression fractures(OVCFs),in order to further illustrate The clinical effectiveness and safety of the latter.Materials and methods:The data of OVCFs patients who underwent PVP surgery in the Spine Surgery Department of Subei People’s Hospital from September 2018 to September 2019 were retrospectively collected.We divided them into traditional group(114 cases)and targeted group(102 cases)according to the surgical method.Example),compare the baseline data of the two groups of patients,including the differences in baseline characteristics such as age,gender,fracture time,bone mineral density T value,surgical segment position,preoperative vertebral compression degree,and fracture location.Record the operation time,fluoroscopy time,blood loss,bone cement injection volume,bone cement leakage rate and leakage type,and observe the filling of bone cement in the fracture area and postoperative complications.Comparison of visual analogue scale(VAS),anterior edge height of vertebral body,and Cobb angle evaluation of kyphotic vertebral body 1 day before operation,3 days after operation,3 months after operation,and 6 months after operation Efficacy.Results:There were no significant differences between the traditional group and the targeted group in the baseline data of the included patients in age,gender,fracture time,bone density,surgical segment position,preoperative vertebral compression degree,and fracture area location.P>0.05).The operation time and fluoroscopy time of the targeted group were shorter than those of the traditional group.Patients in the targeted group had less blood loss,their operation time was short,the fluoroscopy time was less,the amount of bone cement injection was small,and there were significant differences between the two groups(P<0.05).There was a significant difference in the bone cement leakage rate between the two groups(P<0.05).There was no statistically significant difference between the two groups in terms of leakage types(P>0.05).There were statistical differences between the two groups in the filling of bone cement in the fracture area(P<0.05).All patients were followed up for more than 6 months.The visual analogue scores of the two groups were significantly lower than those before treatment at 3 and 6 months after surgery(P<0.05).There was no significant difference between the visual analog scores in the last 3 months and 6 months after operation(P>0.05).All patients were followed up with thoracic and(or)lumbar vertebral X-rays.By the time of follow-up 3 months after operation,all fractured vertebrae healed well and the fracture lines were unclear.At the 3-month follow-up,the height of the anterior edge of the fractured vertebra in the targeted group increased from(2.1±0.2)cm 1 day before surgery to(2.9±0.4)cm at 3-month follow-up,an improvement of 72.13%;The height of the anterior edge of the fractured vertebral body in the traditional group increased from(2.0±0.3)cm 1 day before surgery to(2.4±0.6)cm at 3 months postoperative follow-up,and the improvement rate was 52.0%.There was no statistically significant difference in the height of the anterior edge of the vertebral body one day before the operation(t=2.111,P=0.080),and the difference in the follow-up 3 days after the operation was statistically significant(t=3.110,P=0.011).The difference in monthly follow-up was statistically significant(t=2.902,P=0.023).The height of the anterior edge of the vertebral body in the targeted group recovered more obviously.The Cobb angle of kyphosis in the targeted group decreased from 34.0°1 day before surgery to 22.0° during the 3-month follow-up after surgery,with an average improvement of 12°;the Cobb angle of kyphosis in the traditional group decreased from 1 day before surgery.32° was reduced to 28° in the 3-month follow-up after surgery,with an average improvement of 4°;there was no significant difference between the targeted group and the traditional group one day before surgery(t=1.291,P=0.082),and 3-day follow-up after surgery The difference was statistically significant(t=2.211,P=0.032),and the 3-month follow-up difference was statistically significant(t=2.170,P=0.040).The improvement of the Cobb angle of kyphosis in the targeted group was compared with that in the traditional group,more obvious.Conclusion:Compared with the traditional vertebroplasty for osteoporotic vertebral fractures,the targeted puncture catheter placement combined with side-port push rod technology can reduce fluoroscopy time,operation time,bone cement leakage rate and adjacent vertebral bodies.The incidence of fractures can better ensure that the bone cement is fully filled in the fracture area and reduce the occurrence of poor postoperative curative effects.This is a safe and effective surgical method,which is worthy of clinical application. |
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