中高黏度骨水泥椎体成形术恢复椎体高度疗效比较  

Height Restoration of Compressed Vertebrae after Percutaneous Vertebroplasty with Medium-viscosity Cement and High-viscosity Cement in the Treatment of Osteoporotic Vertebral Compression Fractures

作　　者：汪明星[1] 邓亦奇 赵峰[1] 李国华[1] 陈山成[1] 

机构地区：[1]山东省单县中心医院骨外科,山东菏泽274300

出　　处：《实用骨科杂志》2016年第11期965-969,共5页Journal of Practical Orthopaedics

基　　金：国家临床科研专项课题资助(W2013ZT046)

摘　　要：目的探讨椎体成形术应用中黏度与高黏度骨水泥治疗老年骨质疏松性椎体压缩骨折恢复压缩椎体高度的临床疗效对比。方法回顾性分析2011年10月至2014年3月期间在我院行椎体成形术治疗的158个老年骨质疏松性椎体压缩骨折病例(随访时间大于等于2年),记录患者术中骨水泥注入量,测量手术前、后和随访时病椎的前缘、后凸Cobb角,按使用骨水泥黏度不同分为两组,计算两组术后椎体前缘压缩改善程度及后凸Cobb角矫正度数,对其椎体高度恢复效果进行对比分析。结果中黏度组骨水泥注入量(4.2±1.6)mL,术前椎体前缘平均高度(17.8±5.7)mm、后凸Cobb角(20.3±6.7)°,术后椎体前缘平均高度(22.2±4.2)mm、后凸Cobb角(13.8±4.8)°,术后末次随访椎体前缘平均高度(22.0±4.5)mm、后凸Cobb角(13.1±5.2)°。椎体前缘压缩改善程度(15.1±9.6)%、后凸Cobb角矫正度数(-6.7±5.5)°;高黏度组骨水泥注入量(4.8±1.5)mL,术前椎体前缘平均高度(17.1±5.5)mm、后凸Cobb角(21.8±6.5)°;术后椎体前缘平均高度(23.6±4.7)mm、后凸Cobb角(12.5±5.6)°,术后末次随访椎体前缘平均高度(23.3±4.8)mm、后凸Cobb角(12.8±5.4)°。椎体前缘压缩改善程度(20.7±12.1)%,后凸Cobb角矫正度数(-9.4±7.5)°。两组术中骨水泥注入量比较差异无统计学意义(P>0.05)。两组术后椎体前缘平均高度和后凸Cobb角较术前改善,差异有统计学意义(P<0.05)。高黏度骨水泥组椎体前缘压缩改善程度、后凸Cobb角矫正度数较中黏度组更显著,差异有统计学意义(P<0.05)。结论中、高黏度骨水泥经皮椎体成形术治疗椎体压缩性骨折在恢复椎体高度、改善后凸畸形方面均有一定作用,且应用高黏度骨水泥恢复椎体高度效果更加显著。Objective To compare the clinical efficacy of medium-viscosity cement with high-viscosity cement percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures to restore compressed vertebrae height.Methods Enrolled for this study were 158 vertebrae with osteoporotic vertebral compression fracture who had been treated by PVP in our department from Oct.2011 to Mar.2014 and followed up for at least two year.The cement volume injected were recorded.The anterior vertebral heights and the kyphosis angle were measured preoperative,post operative and at follow-up.They were randomly assigned into two groups according to the bone-cements they used.Postoperative vertebral height restoration,kyphosis correction were compared.Results The average cement volume injected was（4.2±1.6）mL,the average anterior height was（17.8±5.7）mm,cobb angle was（20.3±6.7）°before operation,and the average anterior height was（22.2±4.2）mm,cobb angle was（13.8±4.8）°after operation.The average anterior height was（22.0±4.5）mm,cobb angle was（13.1±5.2）°at follow-up,and anterior compression improvement was（15.1±9.6）%,cobb angle correction degree was（-6.7±5.5）°in the medium-viscosity cement group.The average cement volume injected was（4.8±1.5）mL,the average anterior height was（17.1±5.5）mm,cobb angle was（21.8±6.5）°before operation,and the average anterior height was（23.6±4.7）mm,cobb angle was（12.8±5.4）°after operation and the average anterior height was（23.3±4.8）mm,cobb angle was（12.8±5.4）°at follow-up,and anterior compression improvement was（20.7±12.1）%,cobb angle correction degree was（-9.4±7.5）°in the high-viscosity cement group.There were no significant differences between these 2 groups in bone cement volume injected（P〉0.05）.The average anterior height,cobb angle at postoperation were significantly improved after operation in both groups（P〈0.05）.The anterior compression improvement and cobb angle correction degree of

关 键 词：骨质疏松 椎体压缩骨折 椎体成形术 骨黏合剂 

分 类 号：R683.2[医药卫生—骨科学]