体位复位结合高黏骨水泥椎体成形术治疗椎体压缩性骨折疗效观察

目的 探讨体位复位结合高黏骨水泥在椎体成形术中治疗椎体压缩性骨折的临床疗效。方法 回顾性分析2012年3月～2015年10月接受治疗的单椎体压缩骨折患者159例，其中经皮椎体成形术(percutaneous vertebroplasty，PVP)治疗的56例患者纳入PVP组，经皮椎体后凸成形术(percutaneous kyphoplasty，PKP)治疗的51例患者纳入PKP组，经体位复位结合高黏骨水泥椎体成形术治疗的52例患者纳入高黏骨水泥组，通过术前术后视觉模拟疼痛评分（VAS）、椎体后凸Cobb角的改变以及术后椎体高度恢复率、骨水泥渗漏率，比较3组临床疗效。结果 3组术后VAS评分较各组术前评分均有显著性改善（P<0.05）。椎体高度恢复率PVP组为36%，PKP组75%（χ2=30.792，P=0.021），高黏骨水泥组79%（χ2=37.831，P=0.016），PKP组及高黏骨水泥组较PVP组差异具有统计学意义（P<0.05）。椎体后凸Cobb角PVP组手术前后分别为23.6±1.3、23.0±2.7（t=1.498, P=0.182），PKP组及高黏骨水泥组术前分别为25.7±1.7、26.2±2.3，术后分别为12.8±2.1（t=34.096, P=0.001）、13.3±1.6（t=33.201, P=0.001）。经X线证实PVP组发生骨水泥渗漏8例（14.3%），PKP组发生渗漏3例（5.9%），高黏骨水泥组渗漏3例（5.8%），PKP组及高黏骨水泥组骨水泥渗漏率与PVP组比较具有显著性差异（t=3.886、3.996, P=0.012、0.008）。结论 体位复位结合高黏骨水泥椎体成形术治疗椎体压缩性骨折，可以取得与PKP相同的临床疗效，因其不需使用昂贵的球囊，因而有着良好的临床推广应用前景。

Treatment of osteoporotic vertebral compression fractures by using high viscosity bone cement post hyperextension body position

Objective To evaluate the treatment of osteoporotic vertebral compression fractures by using high viscosity bone cement post hyperextension body position. Methods In this retrospective study, 159 patients divided for PVP(using high viscosity bone cement post hyperextensionbody position), PKP and experimental group,to observe the visual analogue pain score, vertebral Cobb angle change , vertebral height restoration recovery rate, and bone cement leakage rate, to determine the effect of each group retrospectively. Results The postoperative VAS scores of 3 groups were statistically significant (P<0.05), vertebral height recovery rate was 36%, 75%, 79% (P<0.05). The changes of Cobb angle of PVP group and experimental group were significantly different (P<0.05) than that in PVP group after operation. PVP group of bone cement leakage occurred in 8 cases (14.3%), PKP group of 3 cases (5.9%), 3 cases (5.8%) in the experimental group, the PKP group and the experimental group of bone cement leakage rate had statistical significance (P<0.05). Conclussion Postural reduction combined with high viscosity bone cement in the treatment of vertebral compression fractures, can achieve the same clinical efficacy with PKP, and do not need to use expensive balloons, therefore has a good promotion prospects.