改良小剂量骨水泥椎体成形治疗急性骨质疏松性压缩骨折

背景：经皮椎体成形技术已成为临床治疗脊柱骨质疏松性骨折的有效手段，但存在骨水泥渗漏风险。目的：探讨改良小剂量骨水泥椎体成形治疗急性骨质疏松性压缩骨折的效果。方法：选择2008年9月至2011年2月收治的32例骨质疏松性压缩骨折患者进行经皮椎体成形治疗，将患者按照骨水泥注入量分为改良小剂量组和常规剂量组，改良小剂量组骨水泥注入量为2-4 mL，常规剂量组骨水泥注入量为4-6 mL，将同期入院急性骨质疏松压缩骨折因手术禁忌无法进行椎体成形治疗的患者列为对照组。结果与结论：改良小剂量组和常规剂量组末次随访时疼痛缓解及椎体高度恢复率明显优于对照组（P＜0.05）。改良小剂量组骨水泥渗漏率、末次随访时相邻节段椎体继发骨折发生率明显低于常规剂量组（P＜0.05），末次随访时椎体高度恢复率低于常规剂量组（P＜0.05）。说明椎体成形治疗操作过程中，应用改良小剂量骨水泥方法在达到满意临床效果同时，可有效减少骨水泥渗漏、相邻节段继发骨折等并发症发生率。

Percutaneous vertebroplasty with low-dose bone cement for acute osteoporotic vertebral compression fractures

BACKGROUND：Percutaneous vertebroplasty technique has become an effective means for clinical treatment of spinal osteoporotic fractures, but there is the risk of bone cement leakage. OBJECTIVE：To explore the clinical effect of percutaneous vertebroplasty with low-dose bone cement for acute osteoporotic vertebral compression fractures. METHODS：From September 2008 to February 2011, 32 patients with osteoporotic compression fractures were treated by percutaneous vertebroplasty. According to the dose of bone cement, the patients were divided into low dose group （2-4 mL） and routine dose group （4-6 mL）. In addition, another patients who were hospitalized over the same period for acute osteoporotic compression and could not receive vertebroplasty due to urgical contraindication served as control group. RESULTS AND CONCLUSION：The pain relief and vertebral height restoration rate of the low dose group and routine dose group were significantly better than the control group （P＜0.05）. The bone cement leakage rate and last fol ow-up incidence of adjacent segment vertebral fractures of the low dose group were also significantly lower than those in the routine dose group （P＜0.05）. Vertebroplasty with modified low dose bone cement can achieve satisfactory clinical effects, and effectively reduce the leakage of bone cement and incidence of adjacent segment secondary fractures.