高粘度骨水泥治疗椎体压缩性骨折恢复压缩椎体高度临床疗效的影响因素研究  

Influencing factors of clinical efficacy of high viscosity bone cement in the treatment of osteoporotic vertebral compression fractures to restore compressed vertebrae height

作　　者：邓亦奇 汪明星[1] 邓阳[2] 赵峰[1] 

机构地区：[1]单县中心医院骨科,山东菏泽274300 [2]泰山医学院流行病学教研室,山东泰安271000

出　　处：《颈腰痛杂志》2016年第6期459-464,共6页The Journal of Cervicodynia and Lumbodynia

基　　金：国家临床科研专项课题(编号:W2013ZT046)

摘　　要：目的评价高粘度骨水泥治疗椎体压缩性骨折恢复椎体高度的矫正效果及影响因素。方法回顾性分析2013-05-2015-05月期间在我院采用高粘度骨水泥行椎体成形术治疗的107例(123个椎体)压缩骨折患者,记录患者术中骨水泥注入量及骨水泥弥散分布程度,术前与术后椎体前缘、中央高度及后凸Cobb角,计算椎体前缘恢复高度、后凸Cobb角纠正度数,根据骨水泥注入量将患者分为D1组(注入量>4 ml)和D2组(注入量≤4 ml),根据骨水泥弥散分布程度将患者分为V1组(填充率>15%)和V2组(填充率≤15%),比较两组术前与术后椎体前缘、中央高度及后凸Cobb角,对骨水泥注入量、骨水泥弥散程度与骨折椎体恢复高度进行相关分析。结果使用高粘度骨水泥系统注入椎体后近80%椎体高度较术前有不同程度的恢复,平均(4.6±3.8)mm。通过手术前后X线测量比较,椎体前缘压缩改善程度(13.1±10.8)%,椎体中央压缩改善程度(7.3±6.9)%,后凸cobb角平均纠正(-6.5±4.6)°。D1组76椎,D2组47椎,D1组:术前:椎体前缘平均高度(18.4±5.5)mm,椎体中央平均高度(20.8±5.3)mm,后凸Cobb角(21.6±6.7)°;术后:椎体前缘平均高度(24.3±4.7)mm,椎体中央平均高度(24.9±4.8)mm,后凸Cobb角(12.5±5.6)°。D2组:术前:椎体前缘平均高度(17.5±5.7)mm,椎体中央平均高度(19.1±5.6)mm,后凸Cobb角(22.3±6.5)°;术后:椎体前缘平均高度(21.6±6.1)mm,椎体中央平均高度(22.8±5.0)mm,后凸Cobb角(15.6±6.2)°。两组术前和术后椎体前缘平均高度和后凸Cobb角差异有统计学意义(P<0.05)。V1组98椎,V2组25椎,V1组:术前:椎体前缘平均高度(17.9±5.7)mm,椎体中央平均高度(19.2±4.8)mm,后凸Cobb角(20.3±6.7)°;术后:椎体前缘平均高度(23.8±4.2)mm,椎体中央平均高度(23.9±3.8)mm,后凸Cobb角(13.8±4.8)°。V2组:术前:椎体前缘平均高度(18.6±6.2)mm,椎体中央平均高度(21.0±5.8)mm,后凸Cobb角(19.0±6.2)°;术后:椎体前缘平均高度(20.5±6.Objective To evaluate the effects and the influencing factors of high viscosity bone cement in the treatment of osteoporotic vertebral compression fractures to restore compressed vertebrae height. Methods PVP was performed in 107 patients with 123 vertebrae in our department from May 2013 to May 2015. They were randomly assigned into two groups according to the bone cement injection volume, group D1 （cement volume〉4 ml vertebral body volume） and group D2 （cement volume≤4 ml vertebral body volume）, and two groups according to the bone cement injection rate, group V1（cement injection rate〉15% vertebral body volume） and group V2 （cement injection rate ≤ 15% vertebral body volume）. Preoperative and postoperative anterior height, middle height, posterior height and Cobb angle were compared. And we analyzed the correlation between bone cement injection volume, bone cement dispersion and vertebra restoration height. Results Compared to the preoperation, about 80% of vertebra height had different degrees of recovery after vertebra injection using high viscosity bone cement system, the vertebra restoration height was （4.6±3.8）mm. By X-ray measurement in preoperation and postoperation, anterior Compression improvement was （13.1 ±10.8）%, middle compression improvement was （7.3±6.9）% and Cobb angle correction degree was （-6.5±4.6）° There were 76 vertebrae in group D1, and 47 vertebrae in group D2. The average＇anterior height was （18.4±5.5） mm, average middle height was （20.8±5.3） mm and Cobb ＇angle was （21.6±6.7）° at preoperation, and the average anterior height was （24.3±4.7） mm, average middle height was （24.9±4.8）mm and Cobb angle was （12.5±5.6）° at postoperation in＇ group D1. The average anterior height was （17.5±5.7） mm, average middle height was （19.1±5.6） mm and Cobb angle was （22.3±6.5）° at preoperation, and the average anterior height was （21.6±6.1） mm, average middle height was （22.8±5.0）mm and Cobb angle wa

关 键 词：骨质疏松 椎体压缩骨折 椎体成形术 骨粘合剂 

分 类 号：R589[医药卫生—内分泌]