经皮椎体成形术后骨水泥血管内渗漏的相关因素分析  

Analysis of related factors of intravascular leakage of bone cement after percutaneous vertebroplasty

作　　者：宋大江 李业成 SONG Da-jiang;LI Ye-cheng(Dept of Orthopaedics,Shuyang Hospital Affiliated of Xuzhou Medical University,Suqian,Jiangsu 223600,China;Dept of Orthopaedics,Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences,Shanghai 202150,China)

机构地区：[1]徐州医科大学附属沭阳医院骨科,江苏宿迁223600 [2]上海健康医学院附属崇明医院,上海202150

出　　处：《临床骨科杂志》2023年第2期168-172,共5页Journal of Clinical Orthopaedics

摘　　要：目的 分析经皮椎体成形术(PVP)后骨水泥血管内渗漏的相关因素。方法 将100例骨质疏松性椎体压缩骨折患者根据PVP后是否发生骨水泥血管内渗漏分为渗漏组(35例)和非渗漏组(65例)。记录术前Cobb角、体重指数、骨密度、术前椎体裂隙征、椎体内血管分布走形、骨水泥注入量及注入状态、术中穿刺方向、术后骨水泥渗漏情况。结果 患者均获得随访,时间6~9个月。体重指数、骨密度、术前椎体裂隙征、骨水泥注入状态两组比较差异均无统计学意义(P>0.05);术前Cobb角、骨水泥注入量两组比较差异均有统计学意义(P<0.05)。渗漏组T4~T10、T11~L2、L3~L5节段椎体后缘高度、椎弓根高度、血管沟至椎体上缘距离、椎体后缘高度/椎弓根高度、血管沟至椎体上缘距离/椎体后缘高度、血管沟至椎体上缘距离/椎弓根高度比较差异均无统计学意义(P>0.05)。术后骨水泥渗漏率斜行向下穿刺均低于水平方向穿刺、斜行向上穿刺(P<0.05),水平方向穿刺与斜行向上穿刺比较差异无统计学意义(P>0.05)。结论 骨水泥血管内渗漏与术前Cobb角、骨水泥注入量、穿刺方向有关,与体重指数、骨密度、术前椎体裂隙征、骨水泥注入状态无关。Objective To analyze the factors related to the intravascular leakage of bone cement after percutaneous vertebraplasty(PVP).Methods The 100 patients with osteoporotic vertebral compression fractures(OVCFs)were divided into leakage group(35 cases)and non-leakage group(65 cases),according to whether or not bone cement leakage occurred after PVP.Preoperative Cobb angle,body mass index,bone mineral density,preoperative vertebral fissure sign,vascular distribution in the vertebrae,bone cement injection volume and injection status,intraoperative puncture direction,and postoperative bone cement leakage were recorded.Results All patients were followed up for 6~9 months.There were no significant differences in body mass index,bone mineral density,preoperative vertebral fissure sign and bone cement injection status between the two groups(P>0.05).Preoperative Cobb angle,bone cement injection volume were significantly different between the two groups(P<0.05).In the leakage group,for T 4~T 10,T 11~L 2,L 3~L 5 segments,there were no statistically significant differences in the height of vertebral posterior margin,pedicle height,distance from vascular groove to the vertebral superior margin,height of vertebral posterior margin/pedicle height,distance from vascular groove to the superior vertebral margin/height of vertebral posterior margin,distance from vascular groove to the superior vertebral margin/height of pedicle height(P>0.05).The postoperative bone cement leakage rate of oblique downward puncture was lower than that of horizontal puncture and oblique upward puncture,the difference was statistically significant(P<0.05),but there was no statistically significant difference between horizontal puncture and oblique upward puncture(P>0.05).Conclusions The intravascular leakage of bone cement after PVP is related to the preoperative Cobb angle,bone cement volume and the puncture direction,which has not relation with the the body mass index,bone mineral density,preoperative vertebral fissure sign and injection status.

关 键 词：骨质疏松椎体骨折 经皮椎体成形术 骨水泥 血管渗漏 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]