骨水泥量对椎体成形术疗效和渗漏并发症的影响

目的 探讨椎体成形术中注入的骨水泥量对疗效和渗漏的影响. 方法 对2006年7月至2011年5月广州医学院附属广州市第一人民医院脊柱外科收治的186例腰椎骨质疏松性压缩性骨折患者,行椎体成形术,注入聚甲基异丁烯酸( polymethyl methacrylate,PMMA)治疗,对VAS缓解程度和生活质量进行比较. 结果 术后出现骨水泥渗漏73例.出现渗漏患者注入骨水泥量为(4.05±0.76)ml；未出现渗漏患者注入骨水泥量为(3.03 ±0.82) ml,两者统计学上有显著性差异(P=0.000).注入骨水泥量＜3.5 ml者83例,≥3.5 ml者103例,两组术后VAS、疼痛缓解程度、生活质量,在统计学上均未见显著性差异(P＞0.05). 结论 椎体成形术中,注入骨水泥量对疗效影响不大；注入过多的骨水泥会导致渗漏增多.

Clinical Evaluation of the Efficacy of Percutaneous Vertebroplasty and the Influence of Bone Cement Quantity to Leakage

Objective To investigate the efficacy of percutaneous vertebroplasty and the influence of bone cement quantity to leakage.Methods From July 2006 to May 2011,186 osteoporotic vertebral compression fracture patients received vertebroplasty.The polymethyl methacrylate(PMMA) was injected into the body of vertebra.And the visual analogue scale(VAS),the odynolysis and the activity of daily living(ADL) were recorded.Results Leakage occurred in 73 cases.The amount of bone cement was(4.05 ± 0.76)ml and(3.03±0.82) ml in the leakage patients and non-leakage patients(P=0.000).There was no statistically significant difference of VAS,odynolysis and ADL between the 83 cases of <3.5ml PMMA injection and the 103 cases of ≥3.5ml PMMA injection.Conclusion Although the injection volume of bone cement has little effect on the efficacy in percutaneous vertebroplasty,it may increase the risk of excessive leakage.