经皮治疗有无裂隙骨质疏松椎体压缩骨折骨水泥分布及渗漏率比较

目的：比较经皮椎体成形术（ PVP）治疗有无椎体内真空裂隙（ IVC）的骨质疏松椎体压缩骨折（ OVCFs）在骨水泥渗漏的差异。方法回顾性分析284例PVP治疗单节段OVCFs符合纳入标准的患者资料，其中IVC组104例，无IVC组180例。术后所有患者均行X线和CT检查，以评估骨水泥在伤椎内填充形式、有无骨水泥渗漏及渗漏部位，比较两组差异有无统计学意义。结果在IVC组104例患者中，以局限实体团块填充为68例（65．4％），与骨小梁相互嵌插填充为36例；无IVC组180例患者中，以局限实体团块填充为44例，与骨小梁相互嵌插填充为136例（75．6％），两组间比较差异有统计学意义（P＜0．01）。 IVC组有18例（17．3％）、无IVC组有30例（16．7％）发生骨水泥渗漏，组间差异无统计学意义（ P＞0．05）。 IVC组最常见临近椎间盘渗漏，共10例（66．7％）；无IVC组最常见椎前或椎旁静脉渗漏，共22例（73．3％），两组间比较差异有统计学意义（ P＜0．05）。结论 PVP治疗有无IVC的OVCFs在骨水泥渗漏率是类似的，但在骨水泥渗漏部位具有明显差异。

An evaluation of cement distribution patterns and cement leakage after percutaneous vertebroplasty for osteopo-rotic vertebral compression fractures with and without intravertebral vacuum cleft

Objective To compare the difference of polymethylmethacrylate ( PMMA) leakage after percutaneous vertebroplasty ( PVP) for osteoporotic vertebral compression fractures ( OVCFs) with and without intravertebral vacuum cleft (IVC).Methods In total, 284 patients treated for single-OVCF, among whom 104 patients were enrolled in IVC group and 180 patients in non -IVC group, were retrospectively reviewed .The follow -up period was at least 2 years. Plain X-rays and CT were postoperatively performed to investigate PMMA distribution pattern within the affected verte-brae, the presence of PMMA leakage and leakage types .Furthermore, the difference between two groups was compared . Results The local solid lump distribution pattern accounted for 65.4% in IVC group and 24.4% in non-IVC group. The PMMA leakage occurred in 18 (18/104, 17.3%) patients in IVC group and 30 (30/180, 16.7%) patients in non-IVC group, without significant difference (P>0.05).The leakage types that frequently occurred were intradiscal (12/18, 66.7%) in IVC group and perivertebral venous (22/30, 73.3%) in non-IVC group.A significant difference was found in leakage type between the 2 groups.Conclusion The incidences of PMMA leakage in osteoporotic compression fractures with and without IVCs were similar .However, leakage type differs.