高黏度骨水泥灌注联合简化版经皮椎体成形术治疗椎体骨折的临床疗效

The feasibility and clinical efficacy of high viscosity bone cement perfusion combined with simplified percutaneous vertebroplasty in the treatment for vertebrae fractures

目的:研究高黏度骨水泥灌注联合简化版经皮椎体成形术(PVP)治疗骨质疏松性胸腰椎压缩骨折的疗效。方法:回顾性分析65例骨质疏松性胸腰椎压缩骨折患者的临床资料,所有患者均采用高黏度骨水泥灌注联合简化版PVP治疗。记录手术时间、单节椎体骨水泥注入量、伤椎矫正效果、骨水泥渗漏率及邻近椎体再骨折情况,根据视觉模拟量表(VAS)评分和Oswestry功能障碍指数(ODI)评估手术前后患者疼痛缓解及功能恢复情况。结果:患者平均手术时间为(35.8±7.7)min,骨水泥填充量为(2.6±0.8)ml;术中发生骨水泥椎旁渗漏5例(占7.7%),随访期间患者发生邻近椎体再骨折3例(占4.6%),均再次给予PVP治疗。术后患者VAS评分和ODI指数较术前均有显著降低,差异有统计学意义(F=29.592,F=34.628;P<0.05)。术后的伤椎平均高度与末次随访均有显著恢复,其差异有统计学意义(F=7.027,P<0.05)。结论:高黏度骨水泥灌注联合简化版PVP治疗胸腰椎压缩骨折安全有效,操作更为简便,治疗费用更低,且不会增加骨水泥的渗漏率。

Objective To analyze the feasibility and curative efficacy of high-viscosity bone cement combined with simplified percutaneous vertebroplasty （PVP） in the treatment for osteoporotic thoracic and lumbar vertebrae compression fractures. Methods： The clinical data of 65 patients with osteoporotic thoracic and lumbar vertebral compression fractures （OVCF） were research by using retrospective analysis. And then all of them received the treatment of high viscosity bone cement perfusion combined with simplified percutaneous vertebroplasty （S-PVP）. A series of information, such as operative time, bone cement volume of single centrum, corrective effect of injured vertebrae, leakage rate of bone cement and the situation of adjacent vertebral fracture were recorded. According to the score of visual analogue scale （VAS） and Oswestry disability index （ODI） to assess the situations of pain relief and functional recovery before and after operation. Results： The mean of operative time was （35.8±7.7） min, and the bone cement volume was （2.6±0.8）ml. And paraspinal leakage of bone cement in operation happened in 5 cases （7.7%）. And during the follow-up period, 3 patients （4.6%） were found with adjacent vertebral fracture, and all of them received PVP treatment again. The scores of VAS and ODI of post-operation were significantly lower than that of pre-operation（F=29.592, F=34.628, P〈0.05）, respectively. Besides, the average heights of injured vertebra in post-operation and last follow up had been significantly recovered （F=7.027, P〈0.05）. Conclusion： The combination of high viscosity bone cement infusion and S-PVP has series of advantages in the treatment of thoracic and lumbar vertebrae compression fractures that included of safety, efficiency, more simple and convenient operation and lower cost in treatment. And it wouldn＇t increase leakage rate of bone cement.