经皮椎体成形术骨水泥与终板关系对术后椎体高度丢失的影响  

Effects of the relationship between bone cement and endplate on the vertebral height loss after percutaneous vertebroplasty

作　　者：林上进[1] 林伟龙[1] 潘依潇 许乐洋[1] 朱越峰[1] 曹旭海[1] 范永前[1] LIN Shang-jin;LIN Wei-long;PAN Yi-xiao;XU Yue-yang;ZHU Yue-feng;CAO Xu-hai;FAN Yong-qian(Department of Orthopaedics,Huadong Hospital,Fudan University,Shanghai,China)

机构地区：[1]复旦大学附属华东医院骨科,上海200040

出　　处：《复旦学报（医学版）》2018年第2期199-205,共7页Fudan University Journal of Medical Sciences

基　　金：上海市卫计委课题(140612111756534);上海市科委科研计划项目(15411951500)

摘　　要：目的研究经皮椎体成形术(percutaneous vertebroplasty,PVP)骨水泥与终板关系对术后椎体高度丢失的影响。方法回顾性分析2013年6月至2016年5月行PVP术治疗84例单一节段骨质疏松性椎体压缩性骨折的老年女性患者的临床资料,根据术后伤椎正侧位X片和CT检查显示骨水泥与终板的接触情况分为骨水泥与终板接触组(40例,平均年龄76.88岁)和骨水泥与终板非接触组(44例,平均年龄77.96岁),比较两组患者骨水泥灌注量、手术时间、伤椎高度恢复率、术后3个月椎体高度丢失率、术后矢状位Cobb角变化值和骨水泥渗漏率等指标。结果两组患者的年龄、体重指数、术前血钙和磷水平、骨密度值、术前椎体压缩率差异无统计学意义(P>0.05),骨水泥与终板接触组术后椎体高度丢失率和术后矢状位Cobb角变化值明显小于非接触组,差异具有统计学意义(P<0.05)。但两组骨水泥渗漏等指标差异无统计学意义(P>0.05)。结论骨水泥与终板的接触可减少术后椎体高度的丢失,且并不增加骨水泥渗漏率。Objective T o investigate the effects of the relationship between bone cement polymethyl methacrylate(P M M A)and endplate on the vertebral height loss after percutaneous vertebroplasty(P V P).Methods A retrospective analysis of 84 female patients with single segment osteoportic vertebral compression fracture who had undergone PVP between Jun.,2013 and May,2016 was conducted.According to the X-ray radiographs and CT scans,all subjects were divided into the do-PMMA-endplate-contact group(40 cases,average age 76.88 years)and the non-PMMA-endplatecontact group(44 cases,average age 77.96 years).The volume of bone cement,operation time,fractured vertebral height restoration rate,3-month postoperative vertebral height loss rate,changes in local sagitta view Cobb angle and bone cement leakage rate were respectively recorded and compared.Results There were no significant difference in age,body mass index,the levels of serum calcium and phosphorus,bone mineral density and preoperative vertebral body compression rate between the two groups(P>0.05).Postoperative vertebral height loss rate and changes in local sagitta view Cobb angle in the do-PMMA-endplate-contact group were significantly less than the non-PMMA-endplate-contact group(P<C0.05).However,there was no significant difference in bone cement leakage rate between the two groups(P>0.05).C onclusions Making bone cement contact with endplate would reduce the height loss of cemented vertebrae without increasing the rate of cement leakage.

关 键 词：骨水泥 终板 经皮椎体成形术 椎体高度丢失 

分 类 号：R681[医药卫生—骨科学]