PVP术中椎体骨折线内骨水泥弥散情况对疗效的影响

目的探讨经皮椎体成形(PVP)术中骨水泥在椎体骨折线内弥散情况对疗效的影响。方法回顾性分析自2014-01—2016-11行PVP治疗的20例骨质疏松性胸腰椎压缩骨折,根据椎体骨折线内骨水泥弥散情况分为2组(各10例),A组骨水泥在椎体骨折线内充分弥散,B组骨水泥在椎体骨折线内弥散不均匀。比较2组术后4 d、3个月ODI指数、VAS评分、局部后凸Cobb角,以及并发症情况。结果20例均获得3~6(3.82±0.26)个月随访。术后3个月时,A组未出现并发症,B组出现1例椎体再骨折、2例椎体塌陷;B组并发症发生率高于A组,差异有统计学意义(P0.05)。2组术后4 d、3个月的ODI指数、VAS评分、局部后凸Cobb角均较术前明显改善,而且A组术后4 d的ODI指数、VAS评分、局部后凸Cobb角明显低于B组,差异有统计学意义(P0.05)。结论 PVP治疗骨质疏松性胸腰椎压缩骨折可明显改善功能障碍与缓解疼痛程度,但骨水泥在椎体骨折线内弥散不佳会对早期疗效造成影响,甚至可能导致后凸畸形。

Effect of bone cement dispersion in PVP treatment of vertebral fractures

Objective To study the effect of bone cement dispersion on efficacy of percutaneous vertebroplasty (PVP) for the vertebral fractures.Methods Twenty cases of osteoporotic thoracolumbar compression fractures treated with PVP from January 2014 to November 2016 were retrospectively analyzed.The patients were divided into 2 groups according to the vertebral fracture bone cement distribution lines,10 cases each,group A:the bone cement in the vertebral fracture line was in full dispersion,while in group B line the dispersion of vertebral fracture was uneven.The ODI index,VAS score,local kyphosis,Cobb angle,and complications were compared between the 2 groups at 4 d and 3 months postoperatively.Results All the 20 patients were followed up for 3 to 6 months,with an average of (3.82±0.26)months.At 3 months after operation,no vertebral body fracture or vertebral collapse occurred in the group A.There was 1 case of vertebral re-fracture and 2 cases of vertebral collapse in group B.The incidence of complications in group B was higher than that in group A,the difference was statistically significant (P ＜0.05).The 2 group after 4 d,3 months ODI index,VAS score,kyphosis Cobb angle were significantly improved after surgery,and ODI index,VAS score,local kyphosis Cobb angle after 4 d in group A were significantly lower than that of B group,the difference was statistically significant (P ＜0.05).Conclusion PVP for vertebral fractures can significantly improve the degree of pain and dysfunction of the fracture,but bone cement in the vertebral fracture line in poor dispersion will affect the curative effect,and even cause PVP postoperative kyphosis deformity.