椎体成形治疗后骨水泥在椎体内弥散的影响因素

背景：椎体成形及椎体后凸成形可有效治疗骨质疏松性椎体压缩性骨折，但两种手术方式在骨水泥的分布与弥散上有差异。 目的：分析骨水泥行椎体成形或后凸成形治疗骨质疏松椎体压缩性骨折后在椎体内弥散的影响因素。 方法：纳入41例骨质疏松椎体压缩性骨折患者，其中22例进行高黏度骨水泥椎体成形治疗（A组），5例进行高黏度骨水泥椎体后凸成形治疗（B组），14例进行低黏度骨水泥椎体成形治疗（C组）。再根据骨水泥注射量、骨折至手术时间、术前椎体压缩程度将A、C组进行亚组分析。通过CT三维成像和容积再现分析骨水泥在椎体内的分布及弥散。 结果与结论：3组术后骨水泥在椎体内的相对弥散面积及相对弥散体积无明显区别，均能较好地弥散到上下椎板并越过椎体中线。3组骨水泥弥散系数差异无显著性意义。在一定范围内，骨水泥注射量与骨水泥弥散体积呈正相关；A、C组骨水泥弥散系数随骨水泥注射量的增多而降低，随骨折到手术时间的延长而降低，随术前椎体压缩程度的增大而降低，与骨水泥的黏度无明显相关性。

Influencing factors for bone cement dispersion within the vertebral body after vertebroplasty

BACKGROUND：Percutaneous vertebroplasty and kyphoplasty are both effective in the treatment of osteoporotic vertebral compression fractures, but different in the distribution and dispersion of bone cement. OBJECTIVE：To analyze the factors affecting the bone cement dispersion within the vertebral body in treatment of osteoporotic vertebral compression fracture with vertebroplasty or kyphoplasty. METHODS：A total of 41 patients with osteoporotic vertebral compression fractures were included, and divided into three groups：group A （22 cases receiving high viscosity bone cement vertebroplasty treatment）, group B （5 cases receiving high viscosity bone cement kyphoplasty）, group C （14 cases receiving low viscosity bone cement vertebroplasty treatment）. The groups A and C were divided into subgroups according to bone cement injection volume, time from fracture to operation, preoperative degree of vertebral compression. The distribution and dispersion of bone cement in the vertebra were reconstructed by the CT three-dimensional imaging and volume rendering analysis. RESULTS AND CONCLUSION：In the three groups, after operation, relative dispersion area and relative dispersion volume in the vertebrae had no obvious difference, and the bone cement could al diffuse to upper and＆amp;nbsp;lower lamina cross the vertebral midline. There was no significant difference in bone cement diffusion coefficient among the three groups. In a certain range, the bone cement injection volume and bone cement dispersion volume was positively correlated. In groups A and C, bone cement diffusion coefficient decreased with the increasing of bone cement injection volume, time from fracture to operation, and the compression degree of the fractured vertebrae, but showed no significant correlation with bone cement viscosity.