经单侧经皮椎体成形术小剂量与常规剂量骨水泥灌注治疗骨质疏松性椎体压缩骨折的疗效对比研究

Comparative Study on the Curative Effect of Small Dose and Conventional Dose of Bone Cement Perfusion in the Treatment of Osteoporotic Vertebral Compression Fracture by Unilateral Percutaneous Vertebroplasty

目的:探讨经单侧经皮椎体成形术(PVP)小剂量与常规剂量骨水泥灌注治疗骨质疏松性椎体压缩骨折(OVCF)的疗效。方法:回顾性分析2017年3月~2019年2月期间我院收治的OVCF患者92例,均采用经单侧PVP治疗,根据骨水泥灌注剂量将患者分为A组46例和B组46例,A组给予常规剂量(2.6~3.5 m L)骨水泥灌注,B组给予小剂量(1.5~2.5 m L)骨水泥灌注。对比两组围术期指标、视觉模拟评分表(VAS)和Oswestry功能障碍指数(ODI)评分、Cobb角和伤椎椎体前缘高度比、骨水泥渗漏情况及其他并发症发生情况。结果:两组术中出血量、手术时间对比无统计学差异(P>0.05)。对比两组术后1个月、术后6个月VAS、ODI评分无差异(P>0.05),两组术前、术后1个月、术后6个月VAS、ODI评分呈下降趋势(P<0.05)。两组术后1个月、术后6个月Cobb角均较术前减小(P<0.05)。B组术后1个月、术后6个月伤椎椎体前缘高度比较A组更低(P<0.05)。B组渗漏总发生率较A组更低(P<0.05)。对比两组其他并发症无差异(P>0.05)。结论:经单侧PVP小剂量与常规剂量骨水泥灌注治疗OVCF,均可有效改善患者临床症状,减轻疼痛,促进运动功能恢复,但常规剂量骨水泥灌注治疗患者伤椎椎体前缘高度比改善更佳,而小剂量骨水泥灌注渗漏总发生率较低。

Objective: To investigate the efficacy of small dose and conventional dose of bone cement perfusion in the treatment of osteoporotic vertebral compression fractures(OVCF) by unilateral percutaneous vertebroplasty(PVP). Methods: 92 patients with OVCF who came to our hospital from March 2017 to February 2019 were selected, all patients were treated with unilateral PVP, and they were divided into group A with 46 cases and group B with 46 cases according to the perfusion dose of bone cemen. Group A was given conventional dose(2.6~3.5 m L) bone cement perfusion, and group B was given small dose(1.5~2.5 m L) bone cement perfusion. The perioperative indicators, visual analogue scale(VAS) and Oswestry disability index(ODI) score, Cobb Angle and the injured vertebra anterior body height ratio, bone cement leakage and other complications were compared between the two groups. Results: There was no statistical difference in intraoperative blood loss and operative time between the two groups(P>0.05). VAS and ODI scores showed no difference between the two groups at 1 month after operation and 6 months after operation(P>0.05). VAS and ODI scores showed a downward trend in the two groups before operation, 1 month after operation and 6 months after operation(P<0.05). Cobb Angle 1 month and 6 months after operation in both groups decreased compared with that before operation(P<0.05). The injured vertebra anterior body height ratio in group B 1 month and 6 months after operation were lower than that in group A(P<0.05). The total incidence rate of bone cement leakage in group B was lower than group A(P<0.05). There was no difference in other complications between the two groups(P>0.05).Conclusion: Unilateral PVP small dose and conventional dose of bone cement perfusion treatment of OVCF, and which can effectively improve patients’ clinical symptoms, relieve pain, and promote the recovery of motor function. However, the injured vertebra anterior body height ratio in patients treated with conventional dosage of bone cement perfusion is better than the improvement, and the overall incidence of low-dose bone cement perfusion leakage is lower.