经皮椎体成形术中骨水泥注射量跟疗效关系的临床研究

目的 探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)在治疗骨质疏松性椎体压缩骨折中，骨水泥注射量与疗效的关系。方法 应用经皮椎体成形术治疗骨质疏松性椎体压缩骨折75例，共82个椎体。患者在C型臂X线机监测或者CT定位下行PVP治疗，术后行X线片及CT检查并分析骨水泥在椎体的分布，将骨水泥的注射量与椎体病变体积的比例分为4级并以此作为注射量多少的指标。用疼痛视觉类比评分法（visual analogue scale，VAS）测量术前、术后VAS值进行评估。疼痛缓解采用WHO标准进行评估。结果 术后随访6~12个月，平均8.6个月，患者背部疼痛均明显缓解或者消失。术前VAS为（7.3±1.6）分,术后3d VAS为(2.9±1.5)分,术后3个月VAS为(2.6±1.3)分，手术前后的差异均有统计学意义(P＜0.05)。填充比例为1级、2级、3级各组之间的疼痛缓解在统计学上差异无显著性（P＞0.05）。未发现压缩椎体进一步压缩征象。结论 PVP治疗骨质疏松性椎体压缩骨折疗效好, 未见术后治疗椎体进一步压缩，骨水泥注射量与疼痛缓解无联系。

The clinic study of bone cement injection and effect volume in percutaneous vertebroplasty

Objective To evaluate relationship between bone cement injection volume and therapheutical effect in percutaneous vertebroplasty treantment for osteoporotic vertebral compression fracture Methods From January 2005 to February 2009,75 cases of osteoporotic vertebral compression fractures in 82 vertebral bodies were treated. The patients underwent the treatment,which monitored by C-arm fluoroscopy, CT or CTplus C-arm fluoroscopy. They were examined by fluorography and CT after orperation. The distributing of bone cement in vertebral body was analysed.The proportion of the bone cement injection capacity and the volume of pathological changes centrum was divided into 4 levels and regarded it as a quato of the injection capacity. It was evaluated by using visual analogue scale(VAS) to measure the pre- and posttreatment value of VAS. Evaluation of the pain relief is according to criterion of WHO .Results All the cases were flollowed up 6 to 12 months (averaging 8.6 months). Back pain was effectively relieved after operation in all cases.The VAS was (7.3±1.6) points preoperatively ,(2.9±1.5) points in 3d postoperatively,(2.6±1.3)points in 3 month postoperatively. The difference was statistical significance pre- and postoperatively（P＜0.05）. pain relief amang filling 1,2,3grade was not significancal difference. There were no signs of further compression of vertebral body Conclusions The curative effect of PVP was good and stability in treating osteoporotic vertebral fracture. The further collapse of posttreatment vertebral body wasn’t found .The injection volume of bone cement and the pain relief did not interrelate.