经皮椎体后凸成形术中应用高/低黏度骨水泥治疗椎体骨质疏松性骨折

目的对比经皮椎体后凸成形术(PKP)中应用高/低黏度骨水泥对椎体骨质疏松性骨折(OF)患者疼痛缓解、脊柱功能改善的影响。方法 2013年12月—2016年12月,收治脊柱OF患者100例,依据随机数表法分为2组,每组50例,一组PKP术中注入高黏度骨水泥(H组),另一组PKP术中注入低黏度骨水泥(L组)。记录并比较2组单椎体手术时间,骨水泥注入量,术中出血量,骨水泥渗漏率,术前、术后3个月及术后6个月椎体前缘高度、前凸Cobb角、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)。结果 2组单椎体手术时间、骨水泥注入量、术中出血量差异无统计学意义(P> 0.05),H组骨水泥渗漏率明显低于L组,差异有统计学意义(P <0.05)。2组均无骨水泥肺栓塞、邻近椎体骨折等并发症发生。2组术后3个月和6个月椎体前缘高度、前凸Cobb角、VAS评分及ODI与术前相比均明显改善,且H组改善程度均优于L组,差异有统计学意义(P <0.05)。结论与低黏度骨水泥相比,PKP术中应用高黏度骨水泥治疗椎体OF的疗效更确切,可有效恢复椎体生理结构,有利于改善患者的疼痛症状及脊柱功能,值得临床推广。

High/low viscosity bone cement in percutaneous kyphoplasty for vertebral osteoporosis fractures

Objective To compare the effects of high-vs. low-viscosity bone cement on pain relief and spinal function improvement in percutaneous kyphoplasty (PKP) for vertebral osteoporosis fracture (OF). Methods From December 2013 to December 2016, 100 OF patients were recruited and divided into 2 groups according to the random number table method, 50 in each group. One group were injected with high-viscosity bone cement (group H) during PKP operation, the other group with low-viscosity bone cement (group L). The operation time of single vertebral body, bone cement injected, intraoperative hemorrhage and leakage rate of bone cement were recorded and compared between the 2 groups, and also height of anterior vertebral border, Cobb''s angle, visual analogue scale(VAS) score and Oswestry disability index(ODI) at pre-operation, postoperative 3 months and postoperative 6 months. Results There was no difference in operation time of single vertebral body, bone cement injected, and intraoperative hemorrhage between the 2 groups (P>0.05). The leakage rate of cement in group H was significantly lower than that in group L, and the difference was statistically significant (P<0.05). No complications such as pulmonary bone cement embolism and adjacent vertebral fracture occurred in the 2 groups. The height of anterior vertebral edge, Cobb''s angle, VAS score and ODI at postoperative 3 and 6 months in the 2 groups were significantly improved compared with those at pre-operation, and the improvement degree in group H was better than that in group L (P<0.05). Conclusion Compared with low-viscosity bone cement, the application of high-viscosity bone cement in PKP is more effective in the treatment of OF. It can effectively restore the physiological structure of the vertebral body, improve the pain symptoms and spinal function of patients, thus being worthy of clinical popularization.