| Objective: Based on the theory of "residual volume of vertebral body after percutaneous vertebroplasty",to provide an analysis of the relationship between the volume of vertebral body after percutaneous vertebroplasty and untreated vertebral body pain.Methods: In this study,the subjects were patients with osteoporotic vertebral compression fracture(OVCF)who were hospitalized in the Department of spine orthopedics and treated with thoracolumbar percutaneous kyphoplasty(PKP)in the Affiliated Hospital of Shandong University of traditional Chinese medicine from November 2019 to June 2021.According to the inclusion and exclusion criteria,55 patients with OVCF were selected and their names and other general information were obtained before surgical treatment;Arrange patients to measure specific bone mineral density parameters by X-ray dual energy line at lumbar spine or double hips;X-ray examination of spine was taken to measure the height of affected vertebrae and adjacent vertebrae to evaluate the degree of compression of affected vertebrae.The index of postoperative residual pain is to carry out targeted evaluation by using visual analog score(VAS score)and oswsetry dysfunction score(ODI score)one day before operation and the next day after operation.After the operation,CT thin-layer plain scanning with surgical segments as the focus was performed,and the corresponding DICOM files were obtained.The Mimics software was used to analyze and obtain the detailed data of bone cement volume / vertebral volume of different surgical vertebral bodies.Carry out correlation analysis around the influencing factors of postoperative residual pain.After excluding relevant factors,carry out correlation analysis,and use statistical calculation to obtain the recommended range between bone cement volume and vertebral volume.Results: After statistical analysis,there were 9 male patients and 46 female patients in 55 patients with OVCF,with an average age of(76.33 ± 9.15)years.Before operation,the pain time of patients was mainly concentrated in 3 weeks,accounting for 67.27%;Most patients had severe osteoporosis(t ≤-2.5),accounting for69.09%;The average thoracolumbar kyphosis angle was 17.58 ±7.66 °.A total of 65 vertebrae were treated surgically.The affected vertebrae were concentrated between the thoracolumbar segment(T11 ～ L2),accounting for 73.45%;The number of vertebrae in patients was 1,accounting for 83.64%;Most of the affected vertebrae were mild(< 1 / 3)vertebral compression,accounting for56.92%.After operation,the average bone cement volume / vertebral volume was 0.200 ± 0.047;The average improvement rates of ODS and VAI were 70.00% and 60.00%,respectively;Most patients with VAS score improvement were good or even excellent,accounting for 83.64%,while most patients with ODI score improvement were average to good,accounting for 96.36%,indicating that PKP can better reduce patients’ pain,but the functional improvement of patients is limited.There was no correlation between the improvement of VAS score and ODI score,and age,bone mineral density,number of affected vertebrae,preoperative thoracolumbar kyphosis angle and bone cement volume / vertebral volume.The improvement of VAS score was correlated with the time of preoperative pain,and the improvement of ODI score was not correlated with it.Through the correlation study between bone cement volume / vertebral volume and postoperative residual pain,as well as the study of relevant literature,it is concluded that the recommended range of bone cement volume / vertebral volume is 20% ～30%.Conclusion: PKP can effectively treat OVCF,and has the advantages of minimally invasive,analgesic and rapid effect.Mimics based three-dimensional imaging technology can quickly analyze and obtain bone cement volume / vertebral volume.This new index is more suitable for individualized vertebral characteristics,and has very important guiding value for enhancing preoperative planning. |
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