使用不同剂量骨水泥的球囊后凸成型术治疗胸腰段压缩骨折的疗效对比  

Comparison of percutaneous kyphoplasty with different dose of PMMA for the treatment of thoracolumbar vertebral compression fracture

作　　者：李秀成 岳立群 朱国强 

机构地区：[1]北京水利医院创伤科,北京100036

出　　处：《当代医学》2018年第7期11-14,共4页Contemporary Medicine

摘　　要：目的比较使用不同剂量骨水泥的球囊扩张椎体后凸成型术治疗胸腰段压缩骨折的临床疗效。方法回顾性研究自2006年8月~2016年3月本科采用球囊扩张椎体后凸成型术治疗胸腰段压缩骨折90例,其中使用骨水泥≤4.5 ml为A组(30例),使用骨水泥>4.5 ml且≤6 ml为B组(30例),使用骨水泥>6 ml为C组(30例)。术前、术后第2天、术后1个月进行疼痛视觉类比评分(VAS);术后第2天、术后1个月测量椎体前高,并进行统计学分析。结果 A组平均每个椎体注入PMMA(3.58±0.64)ml,术前VAS评分平均为(7.50±0.68)分,术后第2天平均为(2.70±0.75)分,术后1个月为(1.93±0.78)分,骨水泥渗漏率13.3%;B组平均每个椎体注入PMMA(5.32±0.45)ml,术前的VAS评分平均为(7.53±0.73)分,术后第2天平均为(3.13±0.73)分,术后1个月为(2.37±0.67)分,骨水泥渗漏率30.0%;C组平均每个椎体注入PMMA(7.02±0.55)ml,术前的VAS评分平均为(7.57±0.77)分,术后第2天平均为(3.23±0.73)分,术后1个月为(2.63±0.76)分,骨水泥渗漏率46.7%。A组术前骨折椎体前缘的平均高度为(22.56±1.31)mm,术后为(24.12±0.87)mm,术后1个月为(23.97±0.90)mm;B组术前骨折椎体前缘的平均高度为(22.13±0.74)mm,术后为(24.56±0.73)mm,术后1个月为(24.13±0.68)mm,C组术前骨折椎体前缘的平均高度为(22.3±0.70)mm,术后为(24.23±0.72)mm,术后1个月为(23.92±0.79)mm。结论使用不同剂量骨水泥的球囊扩张椎体后凸成型术治疗胸腰段压缩骨折缓解疼痛、维持椎体高度无显著性差异,大剂量骨水泥注入增加渗漏率。Objective To compare the clinical effect of percutaneous kyphoplasty with different dose of PMMA for the treatment thoracolumbar vertebral compression fracture. Methods A total of 90 cases suffering from traumatic thoracolumbar vertebral compression fracture experienced percutaneous kyphoplasty from August 2006 to March 2016 were reviewed. The subjects were divided into three groups according to the dose of bone cement utilized. 30 patients （12 males and 18 females） in group A were filled with bone cement less than 4.5 ml. 30 patients （11 males and 19 females） experienced pereutaneous kyphoplasty in group B were filled with bone cement of 4.5-6 ml. 30 patients （11 males and 19 females） experienced percutaneous kyphoplasty in group C were filled with PMMA more than 6 mL The average ages of these three groups are 68.5, 69.1, and 69.4 respectively for group A, B, and C. The clinical outcome was assessed by visual analog score （VAS） on preoperative, postoperative and final follow up. The heights of anterior vertebral bodies were measured on postoperative and final follow up. Statistical analysis was applied. Results All surgeries were completed successful. The average filled volumes of PMMA in group A, B and C were （3.58 ± 0.64）, （5.32± 0.45）, and （7.02± 0.55） ml, respectively. In group A, the mean VAS score decreased from preoperative（7.50 ± 0.68） to postoperative （2.70 ± 0.75） and （1.93 ± 0.78） for final follow up, the leakage is 13.3%. In group B, the mean VAS score decreased from preoperative （7.53 ± 0.73） to postoperative （3.13± 0.73） and （2.37±0.67） for final follow up, the leakage is 30.0%. In group C, the mean VAS score decreased from preoperative （7.57 ±0.77） to postoperative （3.23±0.73） and （2.63±0.76） for final follow up, the leakage is 46.7%. The mean height of the anterior vertebral body increased from preoperative （22.56±1.31） mm to postoperative （24.12 ± 0.87） mm and（ 23.97 ± 0.9） mm for final follow up in group

关 键 词：骨水泥 椎体后凸成型术 压缩骨折 

分 类 号：R687.3[医药卫生—骨科学]