骨水泥分批灌注经皮椎体后凸成形术治疗伴有椎体后壁骨缺损的骨质疏松性椎体压缩骨折

目的:探讨骨水泥分批灌注经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗伴有椎体后壁骨缺损的骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture, OVCF)的临床效果。方法:回顾性分析我科2016年5月至2020年7月收治的伴有椎体后壁骨缺损的OVCF患者,符合纳入标准和排除标准的32例患者进行了骨水泥分批灌注PKP治疗,记录和比较患者术前及术后1个月、3个月时疼痛视觉模拟评分(visual analog score,VAS),Oswestry功能障碍指数(Oswestry disability index, ODI),伤椎Cobb角和伤椎高度,以及术后骨水泥渗漏和并发症的情况。结果:患者术后随访时VAS、ODI、伤椎Cobb角均显著低于术前(P＜0.05),而术后伤椎高度显著高于术前(P＜0.05)。术后1个月、3个月各指标间差异均无统计学意义(P＞0.05)。共发生骨水泥渗漏3例（9.38%）,无椎管内渗漏病例,未发生神经损伤、肺栓塞等手术并发症。结论:对于伴有椎体后壁骨缺损的OVCF,骨水泥分批灌注PKP是一种安全有效的手术方法,且能有效地减少骨水泥的渗漏。

Treatment of osteoporotic vertebral compression fracture with posterior wall bone defects by percutaneous kyphoplasty with sequential infusion of bone cement

Objective:To evaluate the clinical efficacy of the sequential infusion of bone cement when percutaneous kyphoplasty(PKP) was conducted for the treatment of osteoporotic vertebral compression fracture(OVCF) with posterior wall bone defects. Methods: Patients with posterior wall bone defects OVCF treated in our department from May 2016 to July 2020 were retrospectively analyzed. A total of 32 patients meeting the inclusion and exclusion criteria were treated by the sequential infusion of bone cement when PKP was applied. The visual analog score(VAS), Oswestry disability index(ODI), Cobb angle and height of injured vertebra were recorded and compared before surgery and 1 and 3 months after surgery. Postoperative bone cement leakage and complications were also recorded. Results:The postoperative VAS,ODI and Cobb angle of injured vertebra were significantly lower than those before surgery(P＜0.05).The postoperative height of the injured vertebra was significantly higher than that before surgery(P＜0.05). However, there was no significant differences between follow up results at 1 and 3 months postoperatively(P＞0.05). There were 3 cases (9.38%) of bone cement leakage, without any cases of spinal canal leakage. No surgical complications such as nerve injury and pulmonary embolism were observed. Conclusion:Sequential infusion of bone cement during PKP is a safe and effective surgery for the OVCF with posterior wall bone defects, which could effectively reduce the bone cement leakage.