温差注射法在椎体成形术中预防骨水泥外渗的临床研究

目的:观察温差注射法在椎体成形术(PVP)中预防和减少骨水泥的外渗效果。方法 :对2014年7月至2018年7月收治的42例(48个椎体)骨质疏松性椎体压缩骨折(OVCFs)患者的临床资料进行回顾性分析,男19例,女23例;年龄为62～80岁,平均72岁。椎体骨折节段:T_8-L5,其中腰椎30个,胸椎18个,病程3 d～2个月。其中20例(20个椎体)采用单纯椎体成形术治疗(A组),22例(28个椎体)采用温差注射法治疗(B组)。比较两组患者的手术时间、骨水泥注射量、术后3 d的VAS评分、骨水泥渗漏率及再骨折率。结果:B组患者手术时间、骨水泥注射量、术后3 d VAS评分别为(40.05±7.78) min,(3.93±0.19) ml,(3.55±0.74)分;A组患者分别为(38.90±6.81) min,(4.03±0.24) ml,(4.05±1.00)分,两组比较差异无统计学意义(P0.05)。B组患者渗漏率为9.1%(2/22),比A组患者的40.0%(8/20)更低(P0.05);B组患者再骨折率为9.1%(2/22),A组患者为15.0%(3/20),两组比较差异无统计学意义(P0.05)。结论:温差注射法椎体成形术能有效降低经皮椎体成形术中骨水泥外渗率。

Clinical study of temperature contrast injection procedure in prevention of bone cement leakage during vertebroplasty

Objective:To observe the effect of temperature contrast injection procedure on prevention and reduction of bone cement leakage in vertebroplasty (PVP).

Methods:The clinical data of 42 patients(48 vertebral bodies) with osteoporotic vertebral compression fractures(OVCFs) treated from July 2014 to July 2018 were retrospectively analyzed. There were 19 males and 23 females,aged from 62 to 80 years old with an average of 72 years. The vertebral fracture segment was T₈-L₅,including 30 lumbar vertebrae and 18 thoracic vertebrae. The course of the disease ranged from 3 d to 2 months. Twenty cases (20 vertebral bodies) were treated by single vertebroplasty (group A) and 22 cases (28 vertebral bodies) were treated by temperature contrast injection procedure(group B). The operative time,amount of bone cement injection,VAS score at 3 days after surgery,leakage rate and refracture rate were compared between two groups.

Results:The operative time,amount of bone cement injection and VAS score at 3 days after surgery in group B were (40.05±7.78) min,(3.93±0.19) ml,(3.55±0.74) points,respectively,and in group A were(38.90±6.81) min,(4.03±0.24) ml,(4.05±1.00) points,there was no significant difference between two groups(P>0.05). The leakage rate in group B was lower than that in group A (9.1% vs 40.0%,P<0.05). The refracture rate in group B was 9.1%(2/22),in group A was 15.0%(3/20),there was no significant difference between two groups (P>0.05).

Conclusion:Temperature contrast injection procedure is an effective method to reduce the bone cement leakage in vertebroplasty.