椎体强化术中骨水泥灌注压力与骨水泥渗漏的相关性研究  

Correlation between bone cement injection pressure and leakage in vertebral augmentation

作　　者：郑加法[1] 杨茂伟[1] 李志君[1] 江天蔚[1] 姚琦[1] 苏诗瑶 ZHENG Jiafa;YANG Maowei;LI Zhijun;JIANG Tianwei;YAO Qi;SU Shiyao(Department of Spine Surgery,Dalian No.2 People's Hospital,Dalian,Liaoning 116001,China)

机构地区：[1]大连市第二人民医院脊柱外科,辽宁116011

出　　处：《中国骨与关节损伤杂志》2024年第11期1167-1170,共4页Chinese Journal of Bone and Joint Injury

基　　金：大连市科技创新基金(2022JJ13SN083)。

摘　　要：目的研究椎体强化术中骨水泥灌注压力与骨水泥渗漏的相关性。方法应用羊脊骨标本制作成椎体压缩骨折模型,随机分成两组,33例采用椎体成形术(PVP组),33例采用椎体后凸成形术(PKP组)。在骨水泥面团期时采用可显示压力的骨水泥推注器将骨水泥注入椎体内,出现骨水泥渗漏时记录骨水泥灌注压力和骨水泥灌注量。结果PVP组骨水泥灌注量为(4.49±0.68)mL,PKP组为(5.69±0.74)mL;PVP组骨水泥灌注量小于PKP组,差异有统计学意义(t=5.598,P=0.001)。PVP组骨水泥灌注压力为(48.41±15.46)Psi,PKP组为(51.36±17.67)Psi;两组骨水泥灌注压力差异无统计学意义(t=0.590,P=0.058)。PVP组骨水泥灌注压力达到15Psi时出现骨水泥渗漏,压力到达70Psi时,所有椎体均出现骨水泥渗漏;PKP组骨水泥灌注压力达到20Psi时出现骨水泥渗漏,压力到达80Psi时,所有椎体均出现骨水泥渗漏。结论PKP组较PVP组骨水泥灌注量多,椎体强化术中骨水泥灌注压力低于15Psi时可有效避免骨水泥渗漏。Objective To study the correlation between bone cement injection pressure and leakage during vertebral augmenta-tion.Methods Sheep vertebral compression fracture models were established using vertebral specimens and randomly divided into two groups:33 cases undergoing percutaneous vertebroplasty(PVP group)and 33 cases undergoing percutaneous kypho-plasty(PKP group).During the dough phase of bone cement,a pressure-display cement injector was used to inject cement into the vertebrae,and the injection pressure and volume were recorded upon the occurrence of cement leakage.Results The ce-ment injection volume was(4.49+0.68)mL in the PVP group and(5.69+0.74)mL in the PKP group.The cement injection vol-ume in the PVP group was significantly lower than that in the PKP group(t=5.598,P=0.001).The cement injection pressure was(48.41±15.46)Psi in the PVP group and(51.36±17.67)Psi in the PKP group;there was no significant difference in injection pressure between the two groups(t=0.590,P=0.058).In the PVP group,bone cement leakage occurred when the injection pres-sure reached 15 Psi,and all vertebrae exhibited cement leakage at 70 Psi.In the PKP group,leakage occurred when the pres-sure reached 20 Psi,with all vertebrae showing leakage at 80 Psi.Conclusion The bone cement injection volume in the PKP group was higher than that in the PVP group.Maintaining cement injection pressure below 15 Psi during vertebral augmentation can effectively prevent cement leakage.

关 键 词：椎体压缩骨折 椎体强化术 并发症 

分 类 号：R687.3[医药卫生—骨科学]