PVP手术中骨水泥渗漏至椎间隙与术后疼痛恢复的关系  

Impact of cement leakage on the pain relief followed by percutaneous vertebroplasty in osteoporotic vertebral compression fractures

作　　者：陈晓斌[1] 任继鑫[1] 张建政[1] 李绍光[1] 刘智[1] 

机构地区：[1]北京军区总医院全军创伤骨科研究所,100700

出　　处：《北京医学》2015年第11期1040-1043,共4页Beijing Medical Journal

摘　　要：目的研究经皮椎体成形术（percutaneous vertebroplasty,PVP）中骨水泥渗漏至椎间隙对于患者术后疼痛缓解的影响。方法自2005年1月至2010年3月我科共采用PVP治疗骨质疏松性压缩骨折患者192例,男26例,女166例;年龄60-92岁,平均73.2岁;均为首次且单个椎体的新鲜压缩骨折并接受PVP治疗的患者。收集患者术前一般资料及术后各随访时间点的影像学资料和疼痛评分,随访时间点为术后1周、1个月、6个月、1年、2年。根据骨水泥在术中有无发生渗漏情况分为两组,比较两组患者在术后各随访点疼痛评分及疼痛缓解程度。结果骨水泥未渗漏组（第1组）152例（79%）,渗漏至椎间隙组（第2组）40例（21%）,两组患者的性别、年龄、骨密度、疼痛持续时间方面差异均无统计学意义（P〉0.05）。第1组患者术前VAS平均3.6±1.5,第2组平均3.7±1.3,两组比较差异无统计学意义（P=0.70）。第1组患者骨水泥平均注入量为（4.2±0.5）ml,第2组为（4.1±0.6）ml,两组比较差异无统计学意义（P=0.28）。182例（95%）在术后1周得到随访,165例（86%）在术后1个月得到随访,144例（75%）在术后6个得到随访,103例（54%）在术后1年得到随访,58例（30%）在术后2年得到随访。各随访时间点两组患者VAS评分和疼痛缓解程度的差异均无统计学意义（P〉0.05）。结论骨水泥渗漏至椎间隙,对PVP手术患者术后疼痛的影响与未发生渗漏相比无明显差异。Objective To assess the impact of cement leakage on patient pain relief in osteoporotic vertebral compression fractures（OVCF） followed by percutaneous vertebroplasty（PVP）. Methods From January 2005 to March2010, a total of 192 patients who underwent PVP for OVCF were examined. The image data and pain score（both rest and activity） using pain-intensity numerical rating scale were recorded over a 24-month period. Patients were divided into two groups based on the image analysis. The correlation of the location of cement and pain rating and pain relief degrees at times of follow-up were studied. Results Postprocedure pain numeric scores were similar between the two groups at all time points analyzed（P〈0.05）. Furthermore, pain relief degrees during the follow- up periods were similar between the two groups（P〈0.05）. Conclusion Cement leakage into the disk space has no significant impact on postprocedural pain.

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体成形术 骨水泥渗漏 

分 类 号：R687.3[医药卫生—骨科学]