PKP后骨水泥分布与手术椎体再骨折的关系研究  

Relationship between bone cement distribution and surgical vertebral fractures after PKP

作　　者：陈任[1] 杨博[1] 李孝海[1] 贺斌[1] 余玲[1] 

机构地区：[1]武汉大学人民医院骨外科,武汉420060

出　　处：《颈腰痛杂志》2016年第5期376-379,共4页The Journal of Cervicodynia and Lumbodynia

摘　　要：目的探讨经皮椎体后凸成形术(PKP)后骨水泥的分布情况与患者再发手术椎体骨折的相关性。方法选取本院骨科2009年至2013年采用PKP手术治疗的167例因骨质疏松椎体压缩性骨折患者进行回顾性分析,根据手术后影像学复查骨水泥位置是否偏侧分布分为偏侧组67例和中位组100例,对比两组患者的手术效果指标及术后随访过程中再发骨折率的差异。结果偏侧组患者和中位组患者的骨密度T值、手术注入骨水泥总量、佩戴支具的时间、术前后凸程度、术后首次下地的时间、平均随访时间差异均无统计学意义(P>0.05);术前偏侧组和中位组患者的ODI指数、SI指数、Cobb角、VAS评分差异均无统计学意义(P>0.05);偏侧组患者术后3个月的ODI指数、Cobb角显著的高于中位组(P<0.05),偏侧组患者术后3个月的SI指数显著的低于中位组患者(P<0.05);术后偏侧组的骨水泥渗漏率20.90%、手术椎体再次骨折率16.42%均显著的高于中位组的5.00%和2.00%且差异均具有统计学意义(P<0.05)。结论 PKP后骨水泥出现偏侧分布会影响PKP的手术效果,同时增加术后骨水泥渗漏、手术椎体再次骨折的风险。Objective To investigate the relationship between the distribution of bone cement after percutaneous vertebral body （PKP） and the relationship between the patients with recurrent vertebral fractures. Methods The clinical data of 167 cases with osteoporotic vertebral compression fractures who received PKP surgery in our hospital from 2009 to 2013 were analyzed retrospectively. Based on review of post-operative radiographic lateralization of the distribution of bone cement position, the patients were divided into laterality group （67 cases） and median group （100 cases）. The surgical and postoperative parameters, recurrent fractures rate during follow-up were compared between two groups. Results BMD T-score, the total amount of bone cement implantation surgery, orthosis time, before and after the convex extent postoperative ambulation first time,the average follow-up time between two groups had no significant differences （P〉0.05）. Before operation, the ODI index, SI index, Cobb angle, VAS scores between two groups had no significant differences（P〉0.05）. Three months after operation, ODI index and Cobb angle of unilateral group were significantly higher than those of the median group （P〈0.05）, SI index of laterality group was significantly lower than the median group （P〈0.05）. After operation, the cement leakage rate and vertebral refracture rate of unilateral group were 20.90% and 16.42%, which were significantly higher than 5.00% and 2.00% of the median group, the differences were statistically significant （P〈0.05）. Conclusion After the emergence of unilateral PKP hone cement distribution will affect the outcome of PKP, while increasing the leakage, the risk of bone cement surgery after vertebral fractures again.

关 键 词：经皮椎体后凸成形术 骨水泥 椎体骨折 

分 类 号：R589[医药卫生—内分泌]