骨水泥分布形态对骨质疏松性椎体压缩性骨折手术效果影响  

Effect of Distribution Pattern of Bone Cement on Efficacy in Treatment of Osteoporotic Vertebral Compression Fractures

作　　者：陈建常[1] 马在松[1] 陈文红[1] 滕勇[1] 张春浩[1] 

机构地区：[1]兰州军区乌鲁木齐总医院全军骨科中心,乌鲁木齐830000

出　　处：《解放军医药杂志》2015年第5期82-85,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨骨质疏松性椎体压缩性骨折经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗后椎体内骨水泥分布形态对手术效果的影响。方法选择2006年1月—2013年12月行PVP和PKP治疗的骨质疏松性椎体压缩性骨折440例591节椎体,根据术后X线片骨水泥椎体内分布形态分为致密型组370例,弥散型组70例。比较两组手术时间、透视次数、骨水泥量、住院天数、术后视觉模拟评分(VAS)、改良Oswsetry功能障碍指数(ODI)、Cobb's角、椎体前后缘高度比、骨折部位和手术方法、骨水泥漏及新发椎体骨折发生率。结果平均随访36个月,弥散型组手术时间长于致密型组,骨水泥渗漏率高于致密型组(P<0.01),其他指标两组比较差异无统计学意义(P>0.05)。两组各发生手术椎体再骨折1例,均给予相应治疗。结论椎体内骨水泥呈弥散型分布易发生骨水泥漏,术中透视应多加注意,以防止严重并发症的发生。Objective To explore the distribution pattern of bone cement on efficacy after the percutaneous vertebroplasty（ PVP） and percutaneous kyphoplasty（ PKP） in treatment of osteoporotic vertebral compression fractures（OVCFS）. Methods According to cement distribution in vertebrates shown by postoperative X-ray plate,440 patients（591 vertebraes） with osteoporotic vertebral compression fractures during January 2006 and December 2013 were divided into dense type group（ n = 370） and diffusion type group（ n = 70）. The operation time,X-ray frequency,volume of bone cement,hospital stay,postoperative visual analogue scales（ VAS）,improved Oswesty dysfunction indexes（ ODI）,Cobb＇s angle,the ratio of anterior height / posterior height of vertebrae edges,fracture parts,surgical methods,incidence rates of cement leakage and fresh fracture of vertebra body were compared in the two groups. Results All the patients were followed up for a mean of 36 months,and the operation time was longer and incidence rate of cement leakage was higher in diffusion type group than those in dense type group（ P〈0. 01）,while the differences in other indexes were not statistically significant（ P〉0. 05）. Conclusion Bone cement leakage is often found in the diffusion type,so more attention must be paid during the surgery in order to prevent incidence of severe complications.

关 键 词：脊柱骨折 骨折 压缩性 骨质疏松性骨折 椎体成形术 椎体后凸成形术 

分 类 号：R683.2[医药卫生—骨科学]