高粘度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩骨折的疗效分析

发布时间：2018-03-04 00:10

本文选题：骨质疏松性椎体压缩骨折　切入点：高粘度骨水泥　出处：《中国脊柱脊髓杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的 :比较高粘度骨水泥经皮椎体成形术(PVP)与低粘度骨水泥经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效及影像学特征,评价高粘度骨水泥PVP治疗OVCFs的临床价值。方法:2015年6月~2016年12月我院收治单节段骨质疏松性椎体压缩骨折患者115例,其中65例行高粘度骨水泥PVP(A组),50例行低粘度骨水泥PKP(B组),两组患者年龄、性别、体重指数(BMI)、骨密度(BMD)均无统计学差异。统计两组患者的手术时间、术中透视次数、骨水泥用量、骨水泥渗漏、骨水泥弥散分布情况、伤椎椎体前缘高度和椎体后凸角(Cobb角)、术前和术后VAS评分及ODI等资料,应用SPSS 20.0进行统计学分析。结果:两组患者术后VAS评分、ODI、伤椎椎体前缘高度及Cobb角均较术前显著性改善(P0.01);两组间骨水泥渗漏率无显著性差异;A组手术时间、术中透视次数均显著性少于B组(P0.05)。A组骨水泥单侧弥散分布、双侧不对称分布、双侧对称分布分别为6例(9.2%)、12例(18.5%)、47例(72.3%),未弥散至终板、单侧终板弥散、双侧终板弥散分别为3例(4.6%)、16例(24.6%)、46例(70.8%);B组骨水泥单侧弥散分布、双侧不对称分布、双侧对称分布分别为33例(66.0%)、7例(14.0%)、10例(20.0%),未弥散至终板、单侧终板弥散、双侧终板弥散分别为17例(34.0%)、22例(44.0%)、11例(22.0%),两组间比较有显著性差异(P0.01)。结论:高粘度骨水泥PVP治疗OVCF可获得良好的短期临床疗效,骨水泥可对称地弥散至椎体前柱两侧以及椎体上下终板,使伤椎均衡强化,有利于减少手术椎体再骨折风险,骨水泥渗漏风险与低粘度骨水泥PKP相当。
[Abstract]:Objective: to compare the clinical effects and imaging features of high viscosity bone cement percutaneous vertebroplasty (PVP) and low viscosity bone cement percutaneous kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture. To evaluate the clinical value of high viscosity bone cement (PVP) in the treatment of OVCFs methods: from June 2015 to December 2016, 115 patients with single level osteoporotic vertebral compression fracture were treated in our hospital. There were no significant differences in age, sex, body mass index (BMI) and bone mineral density (BMD) between the two groups in 65 cases of high viscosity bone cement (PVP(A) group and 50 cases of low viscosity cement group (PKP(B group). Bone cement leakage, the distribution of bone cement diffusion, the height of anterior edge of injured vertebrae, the angle of kyphosis of vertebral body, the VAS score before and after operation and ODI, and so on. Results: the postoperative VAS score, the anterior height of vertebral body and the angle of Cobb of the injured vertebrae were significantly improved by SPSS 20.0. Results: there was no significant difference in the leakage rate of bone cement between the two groups and the time of operation in group A. The times of intraoperative fluoroscopy were significantly less than those in group B (P 0.05). Group A was less than group B in the distribution of unilateral dispersion of bone cement, bilateral asymmetrical distribution, and bilateral symmetrical distribution were 6 cases (9.2%) and 12 cases (18. 5%), respectively. There were 47 cases (72.3%) with no diffusion to the end plate and one side of the end plate. In group B, the distribution of bone cement was unilateral and asymmetrical, and the distribution of bilateral asymmetry was 33 cases (66.0%), 7 cases (14.0%) and 10 cases (20.0%), without dispersion to the end plate, and the distribution of unilateral end plate was not diffuse to the end plate, and the distribution of bilateral symmetry was 14.0% (n = 10) and 20.0% (n = 10). The diffusion of bilateral endplates was 17 cases (34.0%) and 22 cases (44.0%). There was a significant difference between the two groups (P 0.01). Conclusion: high viscosity bone cement PVP can obtain good short-term clinical effect for OVCF. Bone cement can spread symmetrically to both sides of the anterior column and the upper and lower endplates of the vertebral body, which makes the injured vertebrae balanced and strengthened, which is helpful to reduce the risk of refracture of the surgical vertebral body. The risk of bone cement leakage is similar to that of the low viscosity bone cement PKP.
【作者单位】：北京大学首钢医院骨科;
【分类号】：R687.3

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