高黏度骨水泥在经皮椎体成形术治疗骨质疏松性椎体压缩性骨折中的应用  

Application of high viscosity bone cement in percutaneous vertebroplasty for treating osteoporotic vertebral compression fracture

作　　者：李晓冬[1] 王素伟[1] 王建钧[1] 向阳[1] 陈燕梅[1] 黄卫[1] 

机构地区：[1]珠海市人民医院脊柱骨病科,广东珠海519000

出　　处：《新乡医学院学报》2015年第12期1095-1097,共3页Journal of Xinxiang Medical University

基　　金：国家卫生计生委医药卫生科技发展研究中心医学科研专项课题(编号:W2012ZT48);珠海市卫生局医学科研课题(编号:2013109)

摘　　要：目的探讨高黏度骨水泥在经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）中的应用效果。方法应用德国Heraeus Medical Gmb H研发的OsteopaⅣ型高黏度骨水泥,行PVP治疗OVCF 57例（共78个椎体）,采用视觉模拟量表（VAS）进行疼痛评分,采用Oswestry功能障碍指数（ODI）进行腰椎功能评分,记录骨水泥注射量、渗漏情况,比较患者术前、术后1 d、1、3个月及末次随访时的椎体前缘高度、后凸Cobb角、VAS疼痛评分、腰椎ODI评分。结果与术前比较,术后1 d、1、3个月及末次随访时患者椎体前缘高度显著增加（P〈0.05）,后凸Cobb角显著减小（P〈0.05）,VAS疼痛评分及腰椎ODI评分显著降低（P〈0.05）。术后1、3个月及末次随访时患者椎体前缘高度、后凸Cobb角、VAS疼痛评分、腰椎ODI评分与术后1 d时比较差异均无统计学意义（P〉0.05）。57例（78个椎体）患者骨水泥注射量为1.5~3.5 m L,平均（2.7±0.4）m L。20个椎体出现骨水泥渗漏,渗漏率为25.6%（20/78）;其中椎旁静脉渗漏率为7.7%（6/78）,椎间隙渗漏率为8.9%（7/78）,椎旁软组织渗漏率为8.9%（7/78）。57例患者均未发生其他严重并发症。结论 PVP注射高黏度骨水泥治疗OVCF能快速缓解患者疼痛,有效恢复椎体高度,且骨水泥渗漏率低,无严重并发症,近期临床疗效良好。Objective To evaluate the effect of high viscosity bone cement in percutaneous vertebroplasty（ PVP） for treating osteoporotic vertebral compression fracture（ OVCF）. Methods Seventy-eight vertebral bodies of fifty-seven patients with OVCF were treated with PVP using Osteopa Ⅳ high viscosity bone cement produced by Heraeus Medical Gmb H in Gernany. The pain of patients were evaluated by visual analogue scales（ VAS）,and the lumbar vertebral function were evaluated by Oswestry disability index（ ODI）. The volume and leakage of bone cement were recorded. The height of anterior vertebral body,kyphosis Cobb angle,VAS score of pain and ODI score of lumbar vertebrae were compared among the time points of preoperative,one day,one month,three months and the last follow-up after operation. Results Compared with preoperative,the height of anterior vertebral body was significantly increased（ P〈0. 05）,kyphosis Cobb angle was significantly less（ P〈0. 05）,the VAS score of pain and ODI score of lumbar vertebrae were significantly decreased at the time points of one day,one month,three months and the last follow-up after operation（ P〈0. 05）. There was no significant difference in the height of anterior vertebral body,kyphosis Cobb angle,VAS score of pain and ODI score of lumbar vertebrae between one day after operation and one month,three month or the last follow-up after operation（ P〉0. 05）. The volume of bone cement in fifty-seven patients（ seventy-eight vertebral bodies） was 1. 5- 3. 5 m L,the average value was（ 2. 7 ± 0. 4） m L. The bone cement leakage occurred in twenty vertebral bodies,the leakage rate was 25. 6%（ 20 /78）. Among them,the paravertebral venous leakage rate was 7. 7%（ 6 /78）,the intervertebral leakage rate was 8. 9%（ 7 /78）,the paravertebral soft tissue leakage rate was 8. 9%（ 7 /78）. There was no other serious complications in the fifty-seven cases. Conclusion Using high viscosity bone cement in PVP for treating OVCF can quickly relieve the pain

关 键 词：高黏度骨水泥 经皮椎体成形术 骨质疏松性椎体压缩性骨折 

分 类 号：R683[医药卫生—骨科学]