伴裂隙征的骨质疏松椎体骨折椎体强化后骨水泥分布模式  

Bone cement distribution patterns of osteoporotic vertebral fractures with intravertebral clefts after vertebroplasty

作　　者：李亮 于学忠 隋海涛 任跃兵 刘广泉 

机构地区：[1]东营市人民医院骨科,山东省东营市257091

出　　处：《中国组织工程研究》2013年第26期4789-4796,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:伴真空裂隙征骨质疏松椎体骨折患者经皮椎体后凸成形治疗后的骨水泥分布模式对疗效是否有影响,国内尚未见相关报道。目的:观察伴真空裂隙征骨质疏松椎体骨折患者经皮椎体后凸成形治疗后两种骨水泥分布模式的临床疗效。方法:回顾性分析2008年2月至2011年11月行经皮椎体后凸成形治疗61例伴真空裂隙征骨质疏松椎体骨折患者的临床资料。测量椎体高度恢复、后凸角矫正情况,记录骨水泥注入量、骨水泥渗漏分布及邻近椎体骨折等并发症情况,以目测类比评分评估腰背部疼痛的程度,Oswestry功能障碍指数评估活动功能受限程度。结果与结论:根据椎体内骨水泥分布的X射线或CT表现分为团块状组29例和海绵状组32例。团块状组骨水泥注射量(5.20±0.62)mL,海绵状组骨水泥注射量(4.80±0.66)mL,组间比较差异有显著性意义(P<0.05)。患者均获得16个月以上的随访,两组治疗后3d及末次随访时目测类比评分、Oswestry功能障碍指数较治疗前明显降低(P<0.05),海绵状组同期疼痛缓解明显优于团块状组(P<0.05)。两组治疗后3d及末次随访时前缘及中线椎体高度、后凸角较治疗前明显恢复(P<0.05),团块状组同期在影像学指数恢复上优于海绵状组(P<0.05)。继发相邻椎体骨折发生率团块状组为14%,海绵状组为6%,组间比较差异有显著性意义(P<0.05)。在漏渗率方面团块状组为17%,海绵状组为25%,组间比较差异有显著性意义(P<0.05)。结果可见海绵状骨水泥分布比团块状分布模式更能有效稳定地缓解疼痛,改善患者生活质量,但漏渗率更高。团块状分布模式比海绵状分布模式更能恢复椎体的高度,治疗后继发相邻椎体的骨折发生率更高。BACKGROUND： There is no domestic research on the effectiveness of bone cement distribution patterns of osteoporotic vertebral fractures with intravertebral clefts after treated by using percutaneous kyphoplasty. OBJECTIVE： To evaluate the clinical effectiveness of bone cement distribution patterns of osteoporotic vertebral fractures with intravertebral clefts after treated by using percutaneous kyphoplasty. METHODS： Between February 2008 and November 2011, the clinical data of 61 patients of osteoporotic vertebral fractures with intravertebral clefts undergoing percutaneous kyphoplasty were retrospectively reviewed. The vertebral height restoration and kyphosis correction were measured, and the injection volume of bone cement, bone cement leakage distribution and adjacent vertebral fractures were recorded. The Visual Analogue Scale score was used to evaluate the degree of low back pain, and the Oswestry disability index was used to evaluate the limitation degree of activity function. RESULTS AND CONCLUSION： According to the vertebral bone cement distribution in the X-ray film or CT image the study was divided into bulky group （n=29） and sponge-like group （n=32）. The bone cement injection volume was （5.20±0.62） mL in the bulky group and （4.80±0.66） mL in the sponge-like group, and there was significant difference between groups （P 〈 0.05）. All patients were followed-up for 16 months. The Visual Analogue Scale score and Oswestry disability index were decreased significantly at 3 days after operation and final follow-up when compared with those before treatment （P 〈 0.05）, and the pain relief in the sponge-like group was better than that in the bulky group （P 〈 0.05）. The frontal vertebral height, midline vertebral height and kyphosis correction in two groups were significantly recoved （P 〈 0.05）, and the restoration rate of imaging index in the bulky group was better that that in the sponge-like group （P 〈 0.05）. The incidence of secondary adjacent vertebral f

关 键 词：骨关节植入物 脊柱植入物 骨质疏松椎体压缩骨折 经皮椎体后凸成形术 骨水泥分布 团块状分布 海绵状分布 椎体高度 后凸角 邻近椎体骨折 

分 类 号：R318[医药卫生—生物医学工程]