不同黏度骨水泥椎体成形系统治疗骨质疏松性椎体压缩性骨折的比较  

Osteoporotic vertebral compression fractures treated by vertebroplasty with bone cements of different viscosity

作　　者：刘洋[1] Liu Yang(Department of Orthopedics,First Affiliated Hospital of Guiyang College of Traditional Chinese Medicine,Guiyang 550001,Guizhou Province,China)

机构地区：[1]贵阳中医学院第一附属医院骨伤科,贵州省贵阳市550001

出　　处：《中国组织工程研究》2018年第30期4774-4781,共8页Chinese Journal of Tissue Engineering Research

摘　　要：背景:椎体成形是微创治疗骨质疏松性椎体压缩性骨折的有效方法之一,骨水泥是最常用的填充材料,但不同黏度骨水泥填充的临床疗效存在争议。目的:比较不同黏度骨水泥椎体成形系统治疗骨质疏松性椎体压缩性骨折的疗效与安全性。方法:将183例骨质疏松性椎体压缩性骨折的患者随机分为4组,高黏度骨水泥经皮椎体成形组、低黏度骨水泥经皮椎体成形组、高黏度骨水泥经皮椎体后凸成形组以及低黏度骨水泥经皮椎体后凸成形组。结果与结论:(1)与经皮椎体成形高黏度骨水泥组相比,经皮椎体成形低黏度骨水泥组手术时间及X射线暴露时间较长;而与经皮椎体后凸成形高黏度骨水泥组相比,经皮椎体后凸成形低黏度骨水泥组手术时间及X射线暴露时间较长;(2)与置入前相比,各组置入后随时间的延长目测类比评分和功能障碍指数评分逐渐降低,且与经皮椎体成形高黏度骨水泥组相比,经皮椎体后凸成形高黏度骨水泥组功能障碍指数评分较低,与经皮椎体成形低黏度骨水泥组相比,经皮椎体后凸成形低黏度骨水泥组功能障碍指数评分较低;(3)与置入前相比,各组置入后随时间的延长后凸Cobb角逐渐减小,伤椎的矢状面指数逐渐增加;与经皮椎体成形高黏度骨水泥组相比,经皮椎体后凸成形高黏度骨水泥组和经皮椎体后凸成形低黏度骨水泥组后凸Cobb角较小,且经皮椎体后凸成形低黏度骨水泥组后凸Cobb角小于经皮椎体后凸成形高黏度骨水泥组;(4)经皮椎体后凸成形高黏度骨水泥组和经皮椎体成形高黏度骨水泥组不良反应发生率较低;(5)提示使用高黏度骨水泥治疗骨质疏松性椎体压缩性骨折安全性与有效性较好,且高黏度骨水泥经皮椎体后凸成形系统的临床疗效最佳。BACKGROUND:Vertebroplasty is one of the effective methods for minimally invasive treatment of osteoporotic vertebral compression fractures.Bone cement as the most commonly used filling material is disputed on its clinical effects of different viscosity.OBJECTIVE:To compare the efficacy and safety of different viscosity bone cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures.METHODS:One hundred and eighty-three patients with osteoporotic vertebral compression fracture were randomly divided into four groups:percutaneous vertebroplasty with high viscosity bone cement group(group A),percutaneous vertebroplasty with low viscosity bone cement group(group B),percutaneous kyphoplasty with high viscosity bone cement group(group C),and percutaneous kyphoplasty with low viscosity bone cement group(group D).RESULTS AND CONCLUSION:(1)The operative time and X-ray exposure time were longer in the two low viscosity bone cement groups than the two corresponding high viscosity bone cement groups,respectively.(2)After operation,visual analogue scale scores and disability index scores were gradually decreased in the all the groups.Compared with the group A,the visual analogue scale score and disability index score were lower in the group C;compared with group B,the visual analogue scale score and disability index score were lower in the group D.(3)After operation,the kyphosis Cobb angle was gradually reduced and the sagittal index of injured vertebrae were gradually increased in all the groups.The postoperative Cobb angle value was ranked as follows:group A>group C>group D.(4)Compared with two low viscosity bone cement groups,two high viscosity bone cement group had lower incidence of adverse events.These findings indicate that high viscosity bone cement has better safety and effectiveness in the treatment of osteoporotic vertebral compression fractures.The clinical efficacy of percutaneous kyphoplasty with high viscosity bone cement is the best among the four systems.

关 键 词：椎体压缩性骨折 骨质疏松 骨水泥 高黏度骨水泥 低黏度骨水泥 经皮椎体成形 经皮椎体后凸成形 骨水泥渗漏率 生物材料 组织工程 骨质疏松性骨折 椎体成形术 组织工程 

分 类 号：R318[医药卫生—生物医学工程]