分次灌注骨水泥技术治疗骨质疏松性椎体压缩骨折疗效观察  

Graded infusion of bone cement in percutanceous vertebroplasty for osteoporotic vertebral compression fractures

作　　者：耿家金[1] 赵平[1] 牛和明[1] 张永强[1] 张强[1] 解平锋 

机构地区：[1]安徽省芜湖市第一人民医院骨科,241000

出　　处：《中国骨与关节损伤杂志》2013年第3期225-227,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨经皮椎体成形术中采用分次灌注骨水泥技术治疗骨质疏松性椎体压缩骨折的安全性与疗效。方法自2009年3月～2011年3月对60例骨质疏松性椎体压缩骨折采用经皮椎体成形术治疗。随机分为一次灌注骨水泥技术组（A组）30例和分次灌注骨水泥技术组（B组）30例。结果本组获随访12—24个月，平均18个月。两组术后症状均明显改善，VAS评分及ODI评分：术后3d及末次随访与术前比较，差异均有统计学意义（P〈0．01），末次随访与术后3d比较，差异无统计学意义（P〉0．05），两组组间比较差异无统计学意义（P〉0．05）；B组骨水泥渗漏率低于A组（P〈0．05），两组均未出现临床症状，无其他严重并发症出现。结论经皮椎体成形术操作简单、安全，能有效地缓解骨质疏松性椎体压缩骨折引起的疼痛，近期疗效满意，但长期疗效仍需进一步观察；术中采用分次灌注骨水泥技术能有效地减少骨水泥渗漏率。Objective To explore the safety and efficacy of graded infusion of bone cement in percutanceous vertebmplasty for ostcopomtic vertebral compression fractures. Methods A total of 60 patients with osteoporotic vertebral compression fractures were treated by pereutanceous vertebroplasty from March 2009 to March 201 I. The cases were randomly and equally assigned to a group of once infusion of bone cement （n=30）（greup A） and a control group of graded infusion of bone cement （n=30） in percutanceous vertebroplasty（group B）. Results The duration of mean follow-up was 18 months （range from 12 to 24 months）. Compared with those before operation, the general condition and symptoms were significantly improved, and the ODI and VAS of two group were dramatically reduced in three days of postoperative and final follow-up（P 〈0.01）. Compared with those three days after operation, the ODI and VAS of final follow-up weren＇t changed （P 〉0.05）. Group comparison of two group did not find significant difference （P 〉0.05）. Compared with group A, the rate of bone cement leakage of group B was lower （P 〈0.05）. But there were no other complications. Conclusion Percutanceous vertebroplasty, with easy performance and safely, can effectively release the pain resulted from osteoporotic vertebral compression fractures and the short-term outcome is favorable. But the long-term effects need to be further observed. Graded infusion of bone cement in percutanceous vertebroplaty can reduce the leakage rate.

关 键 词：压缩性骨折 骨质疏松 椎体成形术 聚甲基丙烯酸甲酯 

分 类 号：R687[医药卫生—骨科学]