高黏度骨水泥经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松压缩骨折的临床疗效观察  

Pereutaneous vertebroplasty with high viscosity of bone cement: pain relief,leakage and vertebral height restoration compared with percutaneous kyphoplasty

作　　者：宋仁谦[1] 周英杰[1] 赵刚[1] 段小波[1] 

机构地区：[1]河南省洛阳正骨医院河南省骨科医院脊柱外二科,洛阳471002

出　　处：《中国矫形外科杂志》2016年第8期692-696,共5页Orthopedic Journal of China

摘　　要：[目的]探讨高黏度骨水泥经皮椎体成形术与经皮椎体后凸成形术两种疗法治疗老年骨质疏松性椎体压缩骨折的疗效。[方法]将63例老年骨质疏松性单一椎体压缩骨折患者随机分为两组,分别采用PKP和高黏度骨水泥经皮椎体成形术治疗,记录两组患者术前术后VAS评分、椎体高度以及两种手术方式的骨水泥注入量、手术出血量、手术时间和骨水泥渗漏发生率,对所得结果进行统计学分析。[结果](1)两组患者手术前后VAS评分改善值、平均骨水泥注入量、骨水泥渗漏发生率比较差异没有统计学意义(P>0.05);(2)高黏度骨水泥经皮椎体成形术组的手术出血量、手术时间少于PKP组且有统计学意义(P<0.05);(3)PKP组术后椎体高度恢复优于高黏度骨水泥经皮椎体成形术组且有统计学意义(P<0.05);(4)术后影像学资料比较,PKP组患者骨水泥分布集中,密度较高;高黏度骨水泥组患者骨水泥呈弥散状分布,密度相对较低。[结论]高黏度骨水泥经皮椎体成形术与PKP治疗老年性椎体压缩骨折均能有效缓解疼痛且效果相当,两者渗漏率无明显差别;PKP在椎体高度恢复方面具有优势,而高黏度骨水泥经皮椎体成形术的手术时间较短,出血量较少。[Objective]To observe clinical effect of pereutaneous vertebroplasty（ PVP） with high viscosity of bone cement and percutaneous kyphoplasty（ PKP） in the treatment of osteoporotic vertebral compressive fracture. [Method]Sixty- three spine fresh fractures were divided into two groups,patients in one group was treated with PKP,and anotther was treated with PVP combined with high viscosity of bone cement. The vertebral height after operation,dose of bone cement injection,operation time,bleeding volume during operation and rate of bone cemen leakage were recorded and compared between two groups. [Result]1）There was no statistical significance between the tow groups about VAS,dose of bone cement injection and rate of bone cemen leakage before and after operation. 2） PVP with high viscosity need less time in opertioin,and caused less operation bleeding,showing significant difference compared with PKP technique. 3） The vertebral height restoration in PKP group was better than that in PVP group,with significant difference（ P 〈 0. 05）. 4） Bone cemen distribution in PVP showed lower density than that in PKP group. [Conclusion]Both of the tow techniques can treat spine fresh fracture effectively and the curative effect is basically the same. There are no abvious differences in bone cemen leakage and dose of bone cement injection between the two grups. PKP techniqu can achived better vertebral height restoration,but need more time in operation and will cause more bleeding.

关 键 词：骨质疏松压缩骨折 高黏度骨水泥经皮椎体成形术 经皮椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]