椎体骨折线内骨水泥弥散情况在经皮椎体成形中的作用

背景：骨水泥在椎体骨折线内的弥散情况可能是影响经皮椎体成形治疗效果的主要因素之一，但目前对此的研究甚少。目的：分析椎体骨折线内骨水泥弥散情况对经皮椎体成形治疗效果的影响。方法：纳入T1-L2骨质疏松性椎体压缩骨折患者77例，其中男28例，女49例，年龄55-86岁，均进行经皮椎体成形治疗，依据治疗后CR、MRI资料将患者分为2组，试验组(n=53)显示骨水泥在椎体骨折线内弥散良好，对照组(n=24)显示骨水泥在椎体骨折线内弥散不均。比较两组治疗前后目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角变化。结果与结论：两组治疗前的目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角比较差异均无显著性意义，两组组内治疗后2 d、6个月的目测类比评分、Oswestry功能障碍指数及骨折椎体局部后凸Cobb角均较治疗前明显改善(P < 0.05)。试验组治疗后第2天的目测类比评分、Oswestry功能障碍指数评分低于对照组(P < 0.05)，两组治疗后6个月的目测类比评分、Oswestry功能障碍指数评分比较差异无显著性意义；试验组治疗后6个月的骨折椎体局部后凸Cobb角小于对照组(P < 0.05)。试验组治疗6个月的椎体塌陷率低于对照组(P < 0.05)，两组间再骨折率比较差异无显著性意义。表明骨水泥在骨折线内弥散不佳会影响近期疼痛及功能障碍的缓解，增大远期发生继发性椎体塌陷的可能性。

Diffusion conditions of bone cement in vertebral fracture line influence the therapeutic effects of percutaneous vertebroplasty

BACKGROUND:Diffusion conditions of bone cement in vertebral fracture line may be one of the main factors affecting the therapeutic effect of percutaneous vertebroplasty, but there are less related studies.OBJECTIVE:To study the effect of diffusion conditions of bone cement in vertebral fracture line on the therapeutic outcomes of percutaneous vertebroplasty. METHODS:CR and MRI data of 77 patients with T1-L2 osteoporotic vertebral compression fractures, 28 males and 49 females, aged 55-86 years, undergoing percutaneous vertebroplasty were analyzed. All the patients were divided into test group (n=53, bone cement diffused well in the vertebral fracture line) and control group (n=24, bone cement dispersion was unsatisfactory). Visual analogue scale, Oswestry disability index and Cobb angle change in the two groups were measured and compared before and after operation. RESULTS AND CONCLUSION:There was no difference in the visual analogue scale score, Oswestry disability index and Cobb angle between the two groups before operation, but these parameters were all improved significantly in the two groups after 2 days and 6 months of operation (P < 0.05). The visual analogue scale score and Oswestry disability index were significantly lower in the test group than the control group at 2 days after operation (P < 0.05), but there was no difference between the two groups at 6 months after operation. The Cobb angle and vertebral collapse rate became lower in the test group than the control group at 6 months after  operation (P < 0.05), but there was no difference in the re-fracture rate between the two groups. These findings indicate that poor bone cement dispersion in the fracture line can affect the relief of short-term pain and dysfunction and it can increase the possibility of long-term secondary vertebral collapse.