两种不同注射材料治疗老年骨质疏松性椎体压缩性骨折疗效评价  

Curative Effects of Two Different Viscosity Bone Cements on Osteoporotic Vertebral Compression Fractures in the Elderly

作　　者：李强[1] 李元[1] Li Qiang;Li Yuan(Department of Orthopedics, Fu Xing Hospital Affiliated to Capital Medical University, Beijing, 100038, P. R. China)

机构地区：[1]首都医科大学附属复兴医院骨科,北京100038

出　　处：《西南军医》2018年第3期301-304,共4页Journal of Military Surgeon in Southwest China

基　　金：卫生部医药卫生科技发展研究中心;编号:W2013ZT030

摘　　要：目的评价两种不同注射材料治疗老年骨质疏松性椎体压缩性骨折疗效。方法自2013年1月至2017年1月接受手术治疗的65岁以上老年骨质疏松性椎体压缩性骨折患者84例,注射PMMA传统骨水泥组36例,注射Confidence高粘度骨水泥48例,对两组患者手术前后及末次随访时的VAS评分、椎体前缘高度、伤椎Cobb角变化及ODI功能评分进行比较。结果所有患者均顺利完成手术。随访6-21个月,平均13.5个月。两组患者术后VAS评分及ODI评分同术前相比均有明显改善,具有统计学意义(P<0.05),而末次随访VAS评分及ODI评分同术后相比,无统计学差异(P>0.05);传统骨水泥组术后椎体前缘高度及Cobb角同术前相比无统计学差异(P>0.05),末次随访椎体前缘高度及Cobb角同术后相比亦无统计学差异(P>0.05);高粘度骨水泥组术后椎体前缘高度及Cobb角同术前相比均有明显改善,具有统计学意义(P<0.05),而末次随访椎体前缘高度及Cobb角同术后相比,无统计学差异(P>0.05)。结论 PMMA传统骨水泥和高粘度骨水泥均为治疗老年骨质疏松性椎体压缩性骨折的有效手段,均能快速缓解疼痛,提高患者生活质量,高粘度骨水泥能同时恢复骨折椎体部分高度。Objective To evaluate the curative effects of two different viscosity bone cements on osteoporotic verte-bral compression fractures in the elderly. Methods 84 elderly over 65 years old with osteoporotic vertebral compression fracture treated surgically during the period from Jan. , 2013 to Jan. , 2017 were enrolled and divided into 2 groups based on the viscosity bone cements selected： PMMA （Polymethacrylates） group （n = 36） and Confidence High - vis-cosity Bone Cement group （n = 48） ; the scores of visual analogue scale （VAS） , height of vertebral anterior margin, Cobb angle, and Oswestry Disability Index（ODI） before surgery, after surgery and of the last follow - up were com-pared in all the cases. Results All the surgical treatments were successful; follow _ up lasted from 6 to 12 months with the average of 13. 5 months; there existed an obvious statistical difference between VAS and ODI scores before surgery and those after surgery in both groups （P 〈 0. 05 ） while no statistical difference between VAS and ODI scores after surgery and those of the last follow - up （ P 〉 0. 05 ） ; the height of vertebral anterior margin and Cobb angle of cases in PMMA group after surgery were of no statistical difference from those before surgery and of the last follow - up （ P 〉 0. 05） ; the height of vertebral anterior margin and Cobb angle of cases in Confidence High - viscosity Bone Cement group after surgery were greatly improved than those before surgery （P 〈 0. 05 ） but were of no statistical difference from those of the last follow - up （P 〉0. 05）. Conclusions PMMA and Confidence High - viscosity Bone Cement are both effective on osteoporotic vertebral compression fractures in the elderly, they can relieve pain quickly and promote the quality of life of the patients, and Confidence High - viscosity Bone Cement, at the same time, can restore certain height of fractured vertebra.

关 键 词：椎体压缩性骨折 经皮穿刺椎体成形术 骨水泥 骨质疏松症 

分 类 号：R683.2[医药卫生—骨科学]