高黏度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床研究  

Clinical outcome of high viscosity bone cement in percutaneous vertebroplasty for osteoporotic vertebral compression fractures

作　　者：李建赤 黄必留[2] 谭加群 梁江声 徐自强 吴春辉 蔡跃波 LI Jianchi HUANG Biliu TAN Jiaqun LIANG Jiangsheng XU Ziqiangl WU Chunhui CAI Yuebo(Department of Orthopedics, Guizhou Hospital, Foshan 528305, Guangdong Department of Orthopedics, Shunde Peace Surgery Hospital Guangzhou University of Traditional Chinese Medicine, Foshan 528308, Guangdong, China)

机构地区：[1]佛山市顺德区桂洲医院骨科,广东佛山528305 [2]广州中医药大学顺德和平外科医院骨科,广东佛山528308

出　　处：《中国骨与关节外科》2016年第4期317-321,共5页Chinese Journal of Bone and Joint Surgery

基　　金：2012年卫生部医药卫生科技发展研究中心基金项目(应用高黏度骨水泥治疗骨质疏松性椎体压缩性骨折临床研究)

摘　　要：背景:经皮椎体后凸成形术(PKP)及经皮椎体成形术(PVP)已成为治疗骨质疏松性椎体压缩性骨折公认有效的方法,但在国内对于高黏度骨水泥及国产椎体成形术手术系统的研究较少。目的:探讨高黏度骨水泥及国产椎体成形术手术系统在.PVP治疗骨质疏松性椎体压缩骨折的临床疗效。方法:根据纳入标准选择2012年10月至2015年2月收治的骨质疏松性椎体压缩骨折患者64例,按随机数字表分为应用高黏度骨水泥的A组32例,39个责任椎;应用低黏度骨水泥的B组32例,41个责任椎。利用视觉模拟评分法(VAS)及功能障碍指数(ODI)对两组进行术前、术后48 h及术后1年的疼痛、活动及运动功能的评价;记录术中单个椎体的骨水泥注入量,术后骨水泥渗漏、再发椎体骨折情况,并进行两组间的比较。结果:A组31例(38个责任椎)和B组30例(39个责任椎)获得随访。两组患者术后48 h、术后1年的ODI及VAS评分与术前相比均有统计学差异(P<0.05);两组患者术前、术后48 h及术后1年的VAS评分和ODI进行组间比较无统计学差异(P>0.05)。两组的骨水泥渗漏率相比较有统计学差异(P<0.05),而骨水泥注入量及再发椎体骨折发生率相比较无统计学差异(P>0.05)。结论:高黏度骨水泥相比低黏度骨水泥在疼痛缓解、脊柱功能恢复、骨水泥注入量、邻近、非邻近椎体再发骨折及原病椎再发骨折的发生率方面效果相当,而高黏度骨水泥可有效减少骨水泥渗漏,是治疗OVCF的理想填充材料。高黏度骨水泥及国产椎体成形术手术系统在PVP治疗骨质疏松性椎体压缩骨折的临床疗效满意。Background：Percutaneous kyphoplasty（PKP） and percutaneous vertebroplasty（PVP） have been proven effective for osteoporotic vertebral compression fractures（OVCF）,but there are few studies on vertebroplasty with high viscosity bone cement and domestic surgical system.Objective：To explore the efficacy of PVP with high viscosity and domestic vertebroplasty system for OVCF.Methods：In accordance with the inclusion criteria,64 patients with OVCF treated in our hospital from October 2012 to February 2015 were enrolled in this study.According to random number table,they were divided into group A（32 cases,39 vertebrae,PVP with high viscosity bone cement） and group B（32 cases,41 vertebrae,PVP with low viscosity bone cement）.Visual analogue scale（VAS） and Oswestry disability index（ODI） were used to evaluate pain and motor function preoperatively,48 h and 1 year postoperatively.The volume of bone cement injected in single vertebra,postoperative bone cement leakage and recurrent vertebral fractures were recorded.Results：Finally,31 patients（38 vertebrae） in group A and 30 patients（39 vertebrae） in group B were followed up.Significant difference was found preoperative and postoperative ODI and VAS scores in both groups（P〈0.05）,but there was no significant difference in ODI score,VAS score,the volume of bone cement or recurrent vertebral fractures between groups（P〈0.05）.There was significant difference in bone cement leakage rate between two groups（P〈0.05）.Conclusions：Compared with low viscosity bone cement,high viscosity bone cement can more effectively reduce leakage and achieve good clinical effect with quick relief of back pain and spinal functional restoration in PVP.

关 键 词：脊柱骨折 椎体成形术 骨质疏松 骨水泥 

分 类 号：R687.3[医药卫生—骨科学] R580[医药卫生—外科学]