Clinical Study On Treatment Of Spinal Lesions By Stage Injection

Objective In this study,the clinical safety and efficacy of percutaneous vertebroplasty were discussed in the treatment of vertebral lesions by means of phased injection,and the difference of clinical curative effect of phased injection in percutaneous vertebroplasty and phased injection was not used in percutaneous vertebroplasty.Method A retrospective analysis of patients with spondylotic spondyloplasty from January 2013 to December 2017 in our hospital and in the East Hospital.According to the operation method adopted in the operation,183 patients were selected for percutaneous vertebroplasty by means of phased injection,the follow-up time was 12 months for all patients and the follow-up was conducted to evaluate the clinical efficacy of the surgery through two indicators – Oswestry disability index(ODI)and visual Analog Score(Vas score).Finally,the statistical processing software is used to process the follow-up data obtained during the follow-up,and carry on the statistical analysis,to evaluate the clinical safety and efficacy of percutaneous vertebroplasty by means of phased injection in the treatment of vertebral lesions.From the clinical database,45 patients who were not treated by phased injection in percutaneous vertebroplasty were selected.Patients with different surgical techniques in both operations were defined as groups A and B: Patients in Group A were treated with phased injection,Group B was the patient who did not use phased injection in the operation.The duration of follow-up was 12 months for all patients,the follow-up was conducted to evaluate the clinical efficacy of the surgery through two indicators – Oswestry disability index(ODI)and visual Analog Score(Vas score).Finally,the statistical processing software is used to process the follow-up data obtained during the follow-up,and carry on the statistical analysis.According to the results,the difference of clinical efficacy between Group A and Group B was compared.All of the follow up data is based on IBM SPSS Statistics 22 statistical analysis software.Result All patients were successfully operated by the same chief physician under the guidance of DSA.The average amount of cement per vertebra was 4.75 ±0.85 ml per segment in patients with phased injection,and 4.23 ±1.16 ml in patients without phased injection.Bone Cement leakage occurred in 81 vertebral bodies(23.89%)of patients undergoing operation by means of phased injection.Bone Cement leakage occurred in 36 vertebral bodies(34.62%)of patients who did not use the phased injection.The leakage of bone cement into surrounding tissues(leakage of intervertebral disc,leakage of spondylotic soft tissue,leakage of paraspinal venous plexus and leakage of spinal canal)did not cause obvious clinical complications.The percentage of patients with excellent and good bone cement distribution in group B was 74.63%(253 patients),which was significantly higher than that in group A(53.85%)(56 patients).Compared with the clinical data before operation,the pain and quality of life were alleviated in different degree in all the patients who were treated by phased injection during the operation.The data of ODI index and VAS score were improved compared with the preoperative index.The difference was statistically significant(P < 0.05).The follow-up data of group A and group B were statistically processed and analyzed.The results showed that there were significant differences in ODI index and VAS score between the two groups 1 day after operation and 1 month after operation(P < 0.05).But there was no significant difference between the two groups at 6 months after operation and 12 months after operation(P > 0.05).Conclusion It is feasible,safe and effective to treat spinal lesions by stage injection during percutaneous vertebroplasty.Compared with the traditional percutaneous vertebroplasty,the phased injection during percutaneous vertebroplasty can increase the coverage of vertebral bone cement,prevent the lateral distribution of bone cement,and bring speed to the patients.The effective clinical effect,especially for the patients with tumor,can maximize the control or inhibition of the tumor of the diseased vertebral body,improve the quality of life of the patients,prolong the survival time of the patients,and for the operators of surgery,The difficulty of operation is reduced.