骨水泥强化椎弓根螺钉内固定治疗骨质疏松伴腰椎退行性疾病效果及影响因素分析

doi:10.3969/j.issn.1006-6233.2020.08.004

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Abstract Objective: To observe the effect of bone cement-reinforced pedicle screw (PMMA-PS) in the treatment of osteoporosis (OP) with disc degenerative disease (DDD) and related factors. Methods: The data of 80 cases of OP with DDD in our hospital from August 2014 to June 2019 were analyzed retrospectively. According to the different therapeutic methods, the patients were divided into PMMA group (n = 37, with PMMA-PS internal fixation treatment) and control group (n = 43, with regular PS internal fixation treatment).The clinical data, operation time, intraoperative blood loss and screw loosening rate were recorded. Before and 3 months after operation, the height of adjacent intervertebral space, the Cobb angle of fixed segment and the visual simulation score of pain (VAS), were observed, as well as the low back pain score of the Japanese Orthopaedic Association (JOA), and the Oswestry Disability Index (ODI). Further, single factor and logistic multiple regression analysis are adopted to analyze the risk factors that affect the recovery effect. Results: Compared with pre-operation date and data of the control group, the height of adjacent intervertebral space, Cobb angle, VAS score, JOA score and ODI index of fixed segment in PMMA group were significantly improved 3 months after operation (P all<0.05). The single factor analysis showed that there was a significant difference in the score of age, bone density, operation, preoperative VAS and pre-operative JOA(P all<0.05).The multiple logistic regression analysis showed that the preoperative VAS score, bone density and operation were the independent factors of the recovery in PS (P all<0.05). Conclusion: Compared with simple PS internal fixation, PMMA-PS internal fixation can effectively improve low back and leg pain in patients with OP with DDD and promote postoperative functional recovery. PMMA-PS internal fixation has certain clinical application value. And the pre-operative VAS score, bone density, and the operation mode can influence the recovery effect, and the prognosis of the patient can be improved by enhancing the bone strengthening mode such as OP treatment and the like.

Key words： Bone cement Screw internal fixation Degenerative disease Osteoporosis

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.08.004 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I8/1246

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