经皮椎体成形术中骨水泥弥散容积比与疗效相关性的临床研究

目的 评价椎体成形术中骨水泥弥散容积比与疗效的关系。方法 2016年1月至2018年5月,43例骨质疏松性椎体压缩骨折患者在我科施行经皮椎体成形术,术后Mimics软件上计算出伤体内骨水泥弥散容积。骨水泥弥散容积比=骨水泥弥散容积/伤锥体积,将骨水泥弥散容积比分为3级,1级<25%,25%<2级<50%,3级>50%,对比术前与术后随访（12个月）的模拟VAS评分与腰疼ODI评分。结果 37例患者实施PVP,术后获12~27个月随访（平均16.8个月）,患者背部疼痛均有不同程度缓解或者消失。骨水泥弥散容积比分为1级、2级、3级各组之间的疼痛缓解疗效的差异无统计学意义（P>0.05）。结论 经皮椎体成形术中骨水泥弥散容积比<25%即可获得满意疗效,增加骨水泥弥散容积比不能获得更好的疗效。

Clinical research of the volume ratio of bone cement on the therapeutic results in percutaneous vertebroplast

Objective To assess the volume ratio of bone cement on the therapeutic results in percutaneous vertebroplasty. Methods From January 2016 to May 2018, 43 patients suffered from osteoporotic vertebral compression fracture were performed percutaneous vertebroplast. CT scans of pre-operative and post-operative were imported into Mimics software and the diffusion volume of bone cement in vertebral body was calculated. Bone cement diffusion volume ratio = bone cement diffusion volume / wound cone volume. Bone cement diffusion volume ratio was divided into three grades, grade 1 <25%, 2550%. The VAS scores and Oswestry Disability Index scores were compared at preoperation, 12 months after operation. Results Thirty-seven vertebral bodies were operated in percutaneous vertebroplast. They were followed up for 12 to 27 months （average 16.8 months）. The back pain of the patients was alleviated or disappeared. There was no significant difference in pain relief between the groups with cement diffusion volume ratio of grade 1, grade 2 and grade 3（P<0.05）. Conclusion In the present study, cement volume ratio less than 25% was an effective therapy for osteoporotic vertebralcompression fractures in vertebroplasty. Increasing the diffusion volume ratio of bone cement couldn't achieve better curative effect.