聚甲基丙烯酸甲酯与自固化磷酸钙骨水泥治疗胸腰椎骨质疏松性骨折的疗效对比  

Comparative study of clinical outcome of pmma and cpc in the treatment of osteoporotic vertebral compression fractures

作　　者：梅平均 姜志强 李颖 吕振京 

机构地区：[1]广东省中西医结合医院脊柱外科,广东佛山528200

出　　处：《西部医学》2017年第8期1088-1091,共4页Medical Journal of West China

基　　金：佛山市科学技术项目(2015AB000802)

摘　　要：目的对比聚甲基丙烯酸甲酯(PMMA)与自固化磷酸钙骨水泥(CPC)治疗胸腰椎骨质疏松性骨折(OVCF)的临床疗效。方法将2013年9月~2015年9月我院收治的90例OVCF患者随机分为两组,均采用经皮椎体成形术(PVP)填充骨水泥治疗:观察组45例采用CPC作为骨水泥材料,对照组45例采用PMMA作为骨水泥材料;对比两组治疗7d后的临床疗效、活动功能恢复情况(EVOS评分、ODI评分)、椎体形态(伤椎前中柱椎体高度和后凸Cobb角角度)及随访1年新发骨折情况。结果两组患者治疗7d后,总有效率均达到97.78%,临床疗效无差异(P>0.05);两组EVOS评分、伤椎前中柱椎体高度和后凸Cobb角角度在治疗后均有明显改善(P<0.05),改善程度观察组与对照组无明显差异(P>0.05);ODI评分(t=5.433,P<0.05)及随访1年新发骨折观察组好于对照组(P<0.05)。结论聚甲基丙烯酸甲酯与自固化磷酸钙骨水泥治疗胸腰椎骨质疏松性骨折均有较好的临床疗效,就疼痛改善的速度和远期效果比较,自固化磷酸钙骨水泥作为PVP填充材料更好。Objective To compare the clinical outcome of PMMA and CPC in the treatment of osteoporotic verte- bral compression fractures （OVCF）. Methods 90 OVCF patients treated with percutaneous vertebral plasty （PVP） were divided into control group and observation group. CPC were used as PVP cement in observation group, while PMMA were used in control group. The clinical efficacy, EVOS and ODI score, posterior vertebral heights, kyphosis Cobb angle 7 days after surgery and total and adjacent new vertebral fractures after 1 year were compared between the two groups. Results The clinical effective rate of control group and observation group was not obviously different （P〉 0.05）. EVOS score, posterior verlebral heights, kyphosis Cobb angle were significantly improved after treatment in the two groups （P 〈 0.05）, but the difference was not obvious between the two groups （P〉 0.05）. ODI score and new vertebral fractures after 1 year of observation group performed significantly better than that of the control group. Conclusion Both PMMA and CPC can act as good methods for PVP treatment in OVCF, but CPC＇s recent analgesic effect and long time support effect are superior to those of PMMA.

关 键 词：骨质疏松性胸腰椎压缩骨折 经皮椎体成形术 聚甲基丙烯酸甲酯 自固化磷酸钙 

分 类 号：R683.1[医药卫生—骨科学]