含rhBMP-2骨水泥在PKP手术治疗胸腰椎骨质疏松性骨折的作用分析  

Effect of rhBMP-2 bone cement on PKP in the treatment of thoracolumbar osteoporotic fracture

作　　者：李荣强 赵俊涛 孙超 LI Rong-qiang;ZHAO Jun-tao;SUN Chao(Hebi People's Hospital,Hebi,Henan 458000,China)

机构地区：[1]河南省鹤壁市人民医院,河南鹤壁458000

出　　处：《颈腰痛杂志》2020年第5期582-585,共4页The Journal of Cervicodynia and Lumbodynia

基　　金：郑州市技术研究与开发经费支持项目(编号:153PKJGG061)。

摘　　要：目的探讨含重组人骨形态发生蛋白-2(recombinant human bone morphogenetic protein-2,rhBMP-2)磷酸钙骨水泥在经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的作用。方法纳入2015年2月~2017年2月在本院脊柱外科治疗的86例单椎骨折OVCF患者,随机均分为两组,对照组采用填充磷酸钙骨水泥的常规PKP手术治疗,观察组填充材料中添加rhBMP-2。记录手术相关指标以及并发症发生情况,并于术前、术后7 d、末次随访时记录VAS评分,影像检查计算伤椎Cobb角以及椎体前缘高度比值,同时测量骨折椎骨密度。结果两组手术时间、住院天数、放射暴露时间的差异均无统计学意义(P>0.05),骨水泥渗漏、慢性腰背痛、再骨折等并发症差异无统计学意义(P>0.05)。两组患者术后7 d、末次随访的疼痛VAS评分、Cobb角较术前均显著降低,伤椎前缘高度比值、骨密度T值显著升高(P<0.05);两组间比较,观察组末次随访时的Cobb角显著低于对照组,伤椎前缘高度比值和骨密度T值显著高于对照组,差异有统计学意义(P<0.05)。结论rhBMP-2骨水泥在PKP手术治疗OVCF过程中,能够提高骨密度、中期支撑效果更好,能减少椎体高度丢失,作用机制可能与rhBMP-2诱导成骨活性及促进骨折愈合有关。Objective To study the effect of recombinant human bone morphogenetic protein-2(rhBMP-2)calcium phosphate cement on percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fracture(OVCF).Methods Eighty-six patients with OVCF who underwent spinal surgery in our hospital from February 2015 to February 2017 were selected in the research.All of them were single-vertebral fractures.They were randomly divided into two groups.The control group used conventional PKP filled with calcium phosphate cement,while rhBMP-2 was added to the filling material in the observation group.The surgical related indicators and complications were recorded.The VAS score was recorded before operation,at 7 days after surgery and the last follow-up.The imaging examination was performed to calculate the Cobb angle of the injured vertebrae and the height of the anterior border of the vertebral body.Results There were no significant differences in the operation time,hospital stay and radiation exposure time between the two groups(P>0.05).There were no significant differences in cement leakage,chronic low back pain and re-fracture(P>0.05).Pain VAS score and Cobb angle were significantly reduced at 7 days after surgery and at the last follow-up in both two groups compared with before surgery,and the ratio of anterior edge height and bone mineral density T value were significantly increased in both two groups(P<0.05).Comparison between the two groups showed that the Cobb angle in the observation group was significantly lower than that in the control group at the last follow-up,and the ratio of anterior edge height and bone mineral density T values in the injured vertebra were significantly higher than those in the control group,with statistically significant differences(P<0.05).Conclusion RhBMP-2 bone cement in the treatment of OVCF with PKP can improve bone mineral density,achieve better medium-term support,and reduce vertebral height loss,which may be related to rhBMP-2 can induce osteogenic activity and promote fractur

关 键 词：RHBMP-2 磷酸钙骨水泥 PKP手术 胸腰椎骨质疏松性骨折 

分 类 号：R683.2[医药卫生—骨科学]