浸骨水泥明胶海绵预填注联合骨水泥分次注射对骨质疏松性胸腰椎骨折经皮穿刺椎体后凸成形术术中骨水泥渗漏的影响  

Effect of bone cement impregnated gelatin sponge pre filling combined with bone cement injection in different times on bone cement leakage during PKP in osteoporotic thoracolumbar fractures

作　　者：付斌[1] 董毅[1] 丁惠强[1] FU Bin;DONG Yi;DING Huiqiang(Department of Spine Orthopedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院脊柱骨科,银川750004

出　　处：《实用医学杂志》2022年第22期2828-2831,2837,共5页The Journal of Practical Medicine

基　　金：宁夏自然科学基金项目(编号:2019AAC03207)。

摘　　要：目的探讨浸骨水泥明胶海绵预填注联合骨水泥分次注射对骨质疏松性胸腰椎骨折经皮穿刺椎体后凸成形术(percutaneous kyphoplasty,PKP)术中骨水泥渗漏的影响。方法选取宁夏医科大学总医院2019年4月至2020年8月收治的88例骨质疏松性胸腰椎骨折患者。采用随机数字表分为2组,对照组术中采用明胶海绵填塞联合骨水泥分次注射,观察组采用浸骨水泥明胶海绵预填注联合骨水泥分次注射。结果观察组明胶海绵用量、骨水泥注入量均少于对照组(P<0.05);2组骨水泥弥散Ⅰ、Ⅱ度占比、术后3个月腰椎功能障碍指数(ODI)评分差异均无统计学意义(P>0.05);观察组术中骨水泥渗漏发生率低于对照组(P<0.05);2组术后即刻椎体后凸角均小于术前(P<0.05),且观察组小于对照组(P<0.05),2组术后即刻伤椎前缘高度均高于术前(P<0.05),且观察组高于对照组(P<0.05);2组均无不良反应;2组邻近椎体骨折发生率比较差异无统计学意义(P>0.05)。结论浸骨水泥明胶海绵预填注联合骨水泥分次注射在骨质疏松性胸腰椎骨折PKP术中应用可减少明胶海绵用量、骨水泥注入量,降低骨水泥渗漏发生率,且可促进伤椎解剖结构恢复。Objective To investigate the effect of bone cement impregnated gelatin sponge pre filling combined with bone cement injection on bone cement leakage during percutaneous kyphoplasty(PKP)for osteoporotic thoracolumbar fractures.Methods 88 patients with osteoporotic thoracolumbar fractures treated in General Hospital of Ningxia Medical University from April 2019 to August 2020 were selected as the subjects,and all of them were planned to undergo PKP treatment.They were randomly divided into two groups.The control group was treated with gelatin sponge packing and bone cement injection,while the study group was treated with bone cement impregnated gelatin sponge pre filling combined with bone cement injection.Results The amount of gelatin sponge and the amount of bone cement injected in the study group were less than those in the control group(P<0.05).There was no significant difference in the proportion ofⅠandⅡdegree of bone cement dispersion,lumbar dysfunction index(ODI)scores at 3 months after operation between the study group and the control group(P>0.05).The incidence of bone cement leakage in the study group was lower than that in the control group(P<0.05).The kyphosis angle of the two groups was smaller than that before operation(P<0.05),and the study group was smaller(P<0.05).The anterior height of injured vertebrae in both groups was higher than that before operation(P<0.05),and the study group was higher(P<0.05).There were no adverse reactions in both groups.There was no significant difference in the incidence of adjacent vertebral fractures between the two groups(P>0.05).Conclusion The application of bone cement impregnated gelatin sponge pre filling combined with bone cement injection in PKP for osteoporotic thoracolumbar fractures can reduce the amount of gelatin sponge and bone cement injection,reduce the incidence of bone cement leakage and promote the recovery of anatomical structure of injured vertebrae.

关 键 词：骨水泥 明胶海绵 骨质疏松症 胸腰椎骨折 经皮穿刺椎体后凸成形术 骨水泥渗漏 

分 类 号：R683.2[医药卫生—骨科学] R452[医药卫生—外科学]