应用不同骨水泥行经皮椎体后凸成形术治疗椎体压缩骨折的对比观察  

Clinical application and comparation of percutaneous kyphoplasty with mineralized collagen-polymethylmethacrylate bone cement and traditional polymethylmethacrylate bone cement in the treatment of vertebral compression fractures

作　　者：孟格栋[1] 银和平[1] Meng Gedong;Yin Heping(Department of Minimally Invasive Spine Surgery, the Second Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, China)

机构地区：[1]内蒙古医科大学第二附属医院微创脊柱外科,呼和浩特市010030

出　　处：《骨科临床与研究杂志》2021年第5期259-264,共6页Journal Of Clinical Orthopedics And Research

基　　金：内蒙古自治区自然科学基金(2019MS08120)。

摘　　要：目的观察矿化胶原复合骨水泥即矿化胶原-聚甲基丙烯酸甲酯(MC-PMMA)骨水泥与聚甲基丙烯酸甲酯(PMMA)骨水泥行经皮穿刺椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的疗效对比。方法2018年6月至2020年6月在内蒙古医科大学第二附属医院微创脊柱外科行经皮穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者314例。按数字表法随机分为矿化胶原复合骨水泥组(MC-PMMA)166例及单纯骨水泥(PMMA)148例。所有患者均为单椎体骨折,分别统计所有患者的年龄、性别、骨密度、随访时间等情况等,比较两组手术时间、术中骨水泥注入量、可推注时间、渗漏及邻近椎体再骨折发生情况。临床疗效评价采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、伤椎前缘高度恢复情况等进行统计分析。结果所有患者手术顺利完成,均获得随访,两组患者的年龄、性别、骨密度值、手术时间、骨水泥注入量、随访时间的差异均无统计学意义。骨水泥推注时间,MC-PMMA组长于PMMA组(t=14.762,P=0.0001)。临床疗效评价术后第1天及术后3个月随访时VSA评分、ODI、椎体前缘相对高度较术前均有统计学意义(P<0.05);两组间不同时间段比较差异无统计学意义(P>0.05)。邻近椎体再骨折发生率MC-PMMA组低于PMMA组(χ^(2)=5.298,P=0.021)。术后骨水泥渗漏率PMMA组高于MC-PMMA组(χ^(2)=6.74,P=0.009)。结论应用MC-PMMA骨水泥与PMMA骨水泥行PKP治疗骨质疏松椎体压缩骨折在止痛效果及伤椎高度恢复方面二者效果相近,但应用前者可降低术后骨水泥渗漏率及邻近椎体继发骨折发生率,疗效显著。Objective To explore the clinical application and comparation of mineralized collagen-polymethylmethacrylate(MC-PMMA)bone cement and polymethylmethacrylate(PMMA)bone cement for percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods Totally 314 cases of fresh single vertebral osteoporotic compression fractures by percutaneous kyphoplasty in Department of Minimally Invasive Spine Surgery,the Second Affiliated Hospital of Inner Mongolia Medical University,were enrolled from June 2018 to June 2020.According to the principle of random,166 cases were treated with mineralized collagen-polymethylmethacrylate(MC-PMMA group)and 148 cases were treated with polymethylmethacrylate bone cement(PMMA group).The basic clinical information including age,sex,bone mineral density,and follow-up time were analyzed.The operation time,injectable volume,injectable time,leakage of bone cement,the occurrence of adjacent vertebral body re-fracture,visual analogue score(VAS),Oswestry dysfunction index(ODI),and the recovery of the height of the anterior column of the injured vertebrae were compared between the two groups.Results The surgeries were finished successfully in all patients.There were no significant differences in age,sex,bone mineral density,operation time,bone cement injection volume and follow-up time between the two groups.The intraoperative cement injectable time was longer in MC-PMMA group(t=14.762,P=0.0001).VSA score,ODI,anterior column heights were significantly improved on the first day and 3 months after operation(P<0.05),but there was no significant difference between the two groups(P>0.05).The incidence of adjacent vertebral re-fracture in MC-PMMA group was was significantly lower than that in the PMMA group.There was significant different between the two groups(χ^(2)=5.298,P=0.021).The leakage rate of bone cement in PMMA group was higher than that in MC-PMMA group(χ^(2)=6.74,P=0.009).Conclusion Both mineralized collagen-polymethylmethacrylate(MC-PMMA)(MC-PMMA)bone

关 键 词：骨质疏松 骨折 压缩性 椎体成形术 甲基丙烯酸甲酯类 

分 类 号：R68[医药卫生—骨科学]