骨填充囊袋对后凸成形骨水泥注入量及渗漏的影响  

Effect of bone-filling mesh container on bone cement injected and leakage in percutaneous kyphoplasty

作　　者：宋方龙 单冰晨[1] 周震涛[1] 周晓中[1] 戴俊 SONG Fang-long;SHAN Bing-chen;ZHOU Zhen-tao;ZHOU Xiao-zhong;DAI Jun(Department of Orthopedics,The Second Affiliated Hospital,Soochow University,Suzhou 215000,China)

机构地区：[1]苏州大学附属第二医院骨科,江苏苏州215000

出　　处：《中国矫形外科杂志》2024年第21期2002-2006,共5页Orthopedic Journal of China

基　　金：国家自然科学基金项目(编号:81902241)。

摘　　要：[目的]探讨骨填充囊袋(bone-filling mesh container,BFMC)对于经皮球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体骨折(osteoporotic vertebral compression fracture,OVCF)中双侧骨水泥注入量及渗漏的影响。[方法]回顾性分析本科2022年10月—2023年7月行单椎体PKP的100例OVCF患者的临床资料,根据医患沟通结果,其中50例接受BFMC-PKP治疗(BFMC组),另50例接受常规双侧PKP治疗(PKP组)。比较临床早期结果与影像资料。[结果]BFMC组囊袋侧的骨水泥推注量[(4.8±0.8)ml vs(2.6±0.6),P<0.001]显著多于PKP侧。BFMC侧推注的骨水泥量[(4.8±0.8)ml vs(4.1±0.9),P=0.030]显著大于PKP组。与术前相比,两组术后3 d VAS评分显著降低(P<0.05),相应时间点,两组VAS评分的差异均无统计学意义(P>0.05)。BFMC组囊袋侧骨水泥渗漏率[例(%),5(10.0)vs 20(40.0),P<0.001]显著低于对侧,BFMC组囊袋侧的骨水泥渗漏率[例(%),5(10.0)vs 14(28.0),P=0.020]显著低于PKP组。骨水泥渗漏较多发生于上终板、侧方以及前方。与术前相比,两组伤椎前缘高度均显著增加(P<0.05),局部后凸角均显著减小(P<0.05)。[结论]BFMC在PKP治疗OVCF时可显著降低同侧的骨水泥渗漏率,但会导致对侧骨水泥注入量减少以及渗漏率的增加。[Objective]To investigate effect of bone-filling mesh container(BFMC)in percutaneous kyphoplasty(PKP)on bilateral bone cement injection and leakage for osteoporotic compression fracture(OVCF).[Methods]A retrospective analysis was performed on 100 patients who received single-segment bilateral PKP in our department from 2022.10 to 2023.7.According to doctor-patient communication,50 of them received BFMC-PKP(the BFMC group),while other 50 received routine bilateral PKP(PKP group).Early clinical results with imaging data were compared.[Results]The bone cement injection volume in the BFMC side group was significantly higher than that in PKP side in the BFMC group[(4.8±0.8)ml vs(2.6±0.6)ml,P<0.001],while the amount of bone cement injected in the BFMC side was also significantly higher than that in PKP group[(4.8±0.8)ml vs(4.1±0.9)ml,P=0.030].The VAS scores significantly declined in both groups 3 days postoperatively compared with that preoperatively(P<0.05),whereas which was not significantly different between the two groups at any time points accordingly(P>0.05).Bone cement leakage rate on BFMC side was significantly lower than that in PKP side in the BFMC group[case(%),5(10.0)vs 20(40.0),P<0.001],and which on BFMC side in the BFMC group was significantly lower than that in PKP group[case(%),5(10.0)vs14(28.0),P=0.020].Most of the bone cement leakage occurred in the upper endplate,lateral and anterior sides.The anterior vertebral height of injured vertebrae increased significantly(P<0.05),while the local kyphotic angle decreased significantly in both groups postoperatively compared with those preoperatively(P<0.05).[Conclusion]In PKP for OVCF,BFMC can significantly reduce the bone cement leakage on the ipsilateral side,but lead to a decrease in the amount of bone cement injection and an increase in the leakage rate on the contralateral side.

关 键 词：骨质疏松性椎体压缩性骨折 经皮后凸成形术 骨填充囊袋 骨水泥 渗漏 

分 类 号：R687[医药卫生—骨科学]