高黏度骨水泥经皮椎体成形术对骨质疏松性胸腰椎骨折患者的有效性及骨密度的影响

目的探究高黏度骨水泥经皮椎体成形术对骨质疏松性胸腰椎骨折患者的有效性及骨密度的影响。方法回顾性分析南阳市中心医院骨科2017年1—2018年12月收治的100例骨质疏松性胸腰椎骨折患者,男性51例,女性49例;年龄43~84岁,平均61.4岁。其中采用低黏度骨水泥经皮椎体成形术治疗患者50例为低黏度组,余50例采用高黏度骨水泥经皮椎体成形术治疗为高黏度组。比较两组VAS评分、Oswestry功能障碍指数(ODI指数)脊柱评分、骨折椎体后凸Cobb角、骨密度(BMD)以及骨水泥渗漏情况。结果术前,两组VAS评分、ODI脊柱评分、椎体后凸Cobb角和BMD水平比较,差异无统计学意义(P>0.05);术后6个月,两组VAS评分、ODI脊柱评分、椎体后凸Cobb角均低于术前,BMD水平高于术前,差异有统计学意义(P<0.05);高黏度组治疗后VAS评分、ODI指数、椎体后凸Cobb角均低于低黏度组,BMD水平高于低黏度组,差异有统计学意义(P<0.05)。低黏度组发生骨水泥渗漏8例,骨水泥渗漏发生率为16%(8/50);高黏度组发生骨水泥渗漏2例,骨水泥渗漏发生率为4%(2/50),两组比较差异有统计学意义(P<0.05)。结论高黏度骨水泥经皮椎体成形术对骨质疏松性胸腰椎骨折的治疗效果明显,可减轻患者术后疼痛,改善脊柱功能,提高骨密度水平,降低骨水泥渗漏发生率,值得推广。

Effect of percutaneous vertebroplasty with high viscosity cement on the efficacy and bone density of patients with osteoporotic thoracolumbar fractures

Objective To investigate the effect of percutaneous vertebroplasty with high viscosity bone cement on the efficacy and bone density of patients with osteoporotic thoracolumbar fractures.Methods Retrospective analysis of the clinical data of 100 patients with osteoporotic thoracolumbar fracture in Department of Orthopaedics of Nanyang Central Hospital from Jan.2017 to Dec.2018(51 males,49 females,mean age,61.4 years)were carried out,including bone cement with low viscosity of 50 patients with percutaneous vertebral plasty treatment as low viscosity group,and the remaining 50 cases using high viscosity bone cement percutaneous vertebral plasty treatment as high viscosity group.Visual analogue pain scale(VAS),Oswestry dysfunction index(ODI),kyphotic Cobb angle,bone density(BMD)and bone cement leakage were compared between the two groups.Results Before operation,VAS,ODI,Cobb's angle of vertebral kyphosis and BMD level of the two groups were compared,and there was no statistically significant difference(P>0.05).At six months after surgery,VAS score,ODI and Cobb's angle of vertebral kyphosis in the two groups were lower than those before surgery,while BMD level was higher than that before surgery,with statistically significant differences(P<0.05).After treatment,VAS,ODI and Cobb's angle of vertebral kyphosis in the high viscosity group were lower than those in the low viscosity group,while BMD level was higher than that in the low viscosity group,with statistically significant differences(P<0.05).Eight cases of bone cement leakage occurred in the low viscosity group,and the incidence of bone cement leakage was 16%(8/50).The incidence of bone cement leakage in the high viscosity group was 4%(2/50),and that in the high viscosity group was lower than that in the low viscosity group(P<0.05).Conclusion The application of percutaneous vertebroplasty with high viscosity bone cement has obvious therapeutic effects on osteoporotic thoracolumbar fractures,which can reduce postoperative pain,improve spinal function,improve bone mineral density,and reduce the incidence of bone cement leakage.