骨质疏松性椎体压缩骨折治疗:椎体成形术(膨胀式)与椎体后凸成形术的对比  

Treatment of osteoporotic vertebral compression fractures:A comparison of vertebroplasty(expansive method)and kyphoplasty

作　　者：华茂奇 王上增[2] 沈锦涛[2] 张英杰 王禛 HUA Maoqi;WANG Shangzeng;SHEN Jintao;ZHANG Yingjie;WANG Zhen(Henan University of Traditional Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学,郑州450003 [2]河南省中医院,郑州450002

出　　处：《实用医学杂志》2020年第11期1478-1482,共5页The Journal of Practical Medicine

基　　金：河南省高等学校重点科研项目(编号:19B390005);河南省中医管理局专项科学研究项目(编号:2019ZY2035);河南省体育局体育课题研究项目(编号:2019024)。

摘　　要：目的比较两种不同方法在骨质疏松性椎体压缩骨折治疗中的安全性及有效性,探讨高黏度骨水泥在临床应用中的优势。方法将56例(82个椎体)骨质疏松性椎体压缩性骨折患者随机分为两组,其中高黏度骨水泥组25例(37椎),低黏度骨水泥组31例(45椎)。记录术中单个病椎骨水泥注入量、骨水泥渗漏情况及不良事件。利用视觉疼痛模拟法(visual analogue scale,VAS)、功能障碍指数(oswestry disability index,ODI)及责任椎Cobb角的恢复情况对两组进行术前及术后1周、1个月不同时限的评价。结果术后1周、1个月VAS、ODI评分及Cobb角较术前均显著改善(P <0.05),术后1周VAS、ODI之间差异无统计学意义(P> 0.05),高黏度组术后1个月VAS、ODI评分及Cobb角恢复度优于对照组,差异具有统计学意义(P <0.05)。所有患者均获得完整随访,其中4例出现骨水泥渗漏情况,无神经根症状,所有患者未出现感染、肺栓塞等并发症。结论两种不同方法在缓解疼痛及恢复功能方面有相似的疗效,椎体成形术(膨胀式)应用的高黏度骨水泥与传统骨水泥相比,在维持椎体Cobb角方面效果更佳,可明显提高灌注过程的安全性及有效性。Objective The research aimed to compare the curative efficacy of two different methods in the treatment of osteoporotic vertebral compression fractures,and to explore the advantages of high viscosity bone cement in clinic.Methods Fifty⁃six OVCF patients(82 vertebras)were randomly divided into two groups.They were divided into high viscosity bone cement group(n=25,37 vertebras performed confidence bone cement)and traditional bone cement(n=31,45 vertebras,performed traditional bone cement).The operation time,amount of bone cement injection,types of bone cement leakage and adverse events were recorded.The visual analogue scale(VAS),recovery of Cobb angle and Oswestry disability index(ODI)in two groups were compared to evaluate the before and after the operation in different time periods of one week and one month.Results The VAS,Cobb angle and ODI score were significantly improved after one week and one month.The difference was statistically significant(P<0.05),There was no significant difference between VAS and ODI at one week and one month after operation(P>0.05).The recovery of Cobb angle in high viscosity bone cement was superior to that in the traditional bone cement group,and the difference was statistically significant(P<0.05).All the patients were obtained follow⁃up and the radicular symptoms were observed in 4 patients.There were no infection and pulmonary embolism occurred in all patients.Conclusion The two treatments have similar efficacy in relieving pain and functional recovery of osteoporotic vertebral compression fractures.It was demonstrated that compared with traditional PMMA bone cement,high viscosity bone cement make significant improvement in correction of Cobb angle.It would increased the efficacy and safety of vertebroplasty.

关 键 词：椎体后凸成形术 骨水泥渗漏 椎体骨折 骨质疏松 骨水泥 

分 类 号：R687.3[医药卫生—骨科学]