不同黏度骨水泥对老年创伤性椎体压缩性骨折疗效及并发症的影响

目的探讨不同黏度骨水泥对老年创伤性椎体压缩性骨折疗效及并发症的影响。方法选取2016年2月—2018年2月海南省中医院收治老年创伤性椎体压缩性骨折98例,其中采用低黏度骨水泥经皮椎体后凸成形术治疗的48例作为低黏度组,而采用高黏度骨水泥经皮椎体后凸成形术治疗的50例作为高黏度组,患者术后随访12个月,比较两组术前与术后3、6、12个月视觉模拟疼痛评分(VAS)、伤椎高度、Cobb角及术后骨水泥渗透情况(椎间隙渗漏、椎管内渗漏、外周血管渗漏、椎旁渗漏)及并发症(肺栓塞、感染、神经损伤)。结果两组治疗后3、6、12个月伤锥高度、Cobb角变化评分与治疗前比较,组间差异具有统计学意义(P<0.05);高黏度组术后3、6、12个月伤锥高度、Cobb角变化明显优于低黏度组,差异有统计学意义(P<0.05);高黏度组术后骨水泥总渗率14.00%低于低黏度组33.33%,组间差异具有统计学意义(P<0.05);两组患者并发症差异无统计学意义(P>0.05)。结论高黏度与低黏度骨水泥均能改善患者疼痛,高黏度骨水泥渗漏率与伤锥恢复情况均优于低黏度骨水泥。

Effect of treatment and complications on different viscosity bone cement on the elderly patients with traumatic vertebral compression fracture

Objective To investigate the effect of treatment and complications on different viscosity bone cement on the elderly patients with traumatic vertebral compression fracture(VCF).Methods 98 patients with VCF,all aged>65,were randomly divided into 2 groups:low-viscosity group(n=48)undergoing vertebroplasty with polymethymethacry‐late(PMMA)bone cement,and high-viscosity group(n=50)undergoing vertebroplasty with high-viscosity Confidence bone cement.The patients were followed up 3,6,and 12 months after the operation.The visual analogue scale(VAS)was used to evaluate the pain degree.The height of the injured vertebrae,and the Cobb angle as well as postoperative cement penetration(intervertebral space leakage,intraspinal leakage,peripheral vascular leakage,paraspinal leakage)were measured by X-ray.Complications(pulmonary embolism,infection,nerve damage,etc.)were recorded.Results There were no significant difference in pain degree at 3,6,and 12 months after the operation.The height of the injured vertebrae and Cobb angle at 3,6,and 12 months after treatment of both groups were all statistically lower than those before treatment in both groups(all P<0.05).The height of the injured vertebrae and Cobb angle at 3,6,and 12 months after treatment of the high-viscosity group were all statistically lower than those of the low-viscosity group(all P<0.05).The total leakage rate of bone cement of the high-viscosity group was 14.00%,significantly lower than that of the low viscosity group(33.33%,P<0.05).There was no significant difference in the complication rate between these 2 groups(P>0.05).Conclusion Both high-viscosity and low-viscosity bone cement improve the pain of the elderly patients with VCF,while the high-viscosity cement shows lower leakage rate and higher recovery rate of the injured vertebrae.