骨水泥体积分数对单侧经皮椎体后凸成形术后相邻椎体骨折的影响  

Effect of bone cement volume fraction on adjacent vertebral fractures after unipedicular percutaneous kyphoplasty

作　　者：林达生[1] 郝健明[1] 李林[1] 王雷[1] 张焕堂[1] 邹为涛[1] 练克俭[1] 

机构地区：[1]解放军第一七五医院全军骨科中心(厦门大学附属东南医院骨科),福建省漳州市,363000

出　　处：《中华创伤骨科杂志》2014年第9期765-769,共5页Chinese Journal of Orthopaedic Trauma

摘　　要：目的 探讨单侧椎体经皮后凸成形术后骨水泥体积分数与相邻椎体骨折（AVF）的关系. 方法 对2006年1月至201 1年12月收治的495例单节段骨质疏松性椎体压缩骨折行单侧PKP的患者资料进行回顾性分析.根据椎体新发骨折分为3组：AVF组（52例）、非AVF组（58例）和非骨折组（385例）.比较AVF组患者的骨水泥体积分数与其他两组的差异,同时比较3组患者的骨水泥渗漏率、手术前、后cobb角及视觉模拟评分（VAS）.结果 AVF组骨水泥体积分数（32.5％±5.5％）高于非AVF组（27.3％±1.8％）和非骨折组（27.0％±2.6％）,差异均有统计学意义（P＜0.05）.AVF组骨水泥渗漏率（36.5％,19/52）高于非AVF组（20.7％,12/58）和非骨折组（17.7％,68/385）,差异均有统计学意义（P＜0.05）.3组患者术后的cobb角和VAS评分均较术前明显改善,差异有统计学意义（P＜0.05）,但手术前、后cobb角和VAS评分3组间两两比较差异均无统计学意义（P＞0.05）. 结论 根据骨水泥体积分数决定骨水泥用量可获得良好效果,AVF和骨水泥渗漏的风险随骨水泥体积分数增加而增加.Objective To assess the relationship between bone cement volume fraction and adjacent vertebral fracture （AVF） after unipedicular percutaneous kyphoplasty （PKP）.Methods We reviewed 495 patients with osteoporotic vertebral compression fracture （OVCF） of single level who had been surgically treated by unilateral PKP between January 2006 and December 2012 and completed a 12-month follow-up.According to presence or absence of new vertebral fracture,they were divided into 3 groups：AVF group （52 cases）,Non-AVF group （58 cases） and No Fracture group （385 cases）.The bone cement volume fraction for the vertebral body in the AVF group was compared with those in the other 2 groups; cement leakage,preoperative and postoperative cobb angles,and visual analogue scale （VAS） scores were compared between the 3 groups.Results The cement volume fraction in AVF group （32.5% ± 5.5%） was significantly higher than in Non-AVF group （27.3% ± 1.8%） and No Fracture group （27.0% ± 2.6%） （P 〈 0.05）.The rate of cement leakage in AVF group （36.5%,19/52） was significantly higher than in Non-AVF group （20.7%,12/58） and No Fracture group （17.7%,68/385） （P 〈 0.05）.There were no significant differences regarding preoperative and postoperative cobb angles or VAS scores among the 3 groups （P 〉 0.05）,though the preoperative cobb angle and VAS scores in the 3 groups were all significantly improved after operation （P 〈0.05）.Conclusion Although unipedicular PKP is an effective and safe procedure for patients with OVCF,cement volume should be determined according to the vertebral body fraction to obtain a favorable outcome,because the risks of AVF and cement leakage will increase obviously with increased cement volume fraction.

关 键 词：脊柱骨折 骨质疏松 椎体成形术 骨水泥 体积分数 

分 类 号：R683.2[医药卫生—骨科学]