单侧经皮聚甲基丙烯酸甲酯骨水泥椎体成形治疗中骨水泥注入位置、注入量与疗效的相关性

Relationship of insertion site and amount with effectiveness of polymethylmethacrylate bone cement in unipedicular percutaneous kyphoplasty

背景:经皮聚甲基丙烯酸甲酯骨水泥椎体后凸成形治疗骨质疏松性椎体压缩骨折能迅速缓解患者疼痛症状,效果良好。目的:验证单侧经皮聚甲基丙烯酸甲酯骨水泥椎体后凸成形治疗骨质疏松性椎体压缩骨折的疗效。方法:回顾性分析22例新鲜骨质疏松性椎体压缩骨折行单侧经皮聚甲基丙烯酸甲酯骨水泥椎弓根穿刺椎体后凸成形治疗患者的临床资料。结果与结论:22例患者平均随访2.5年,渗漏率为4.5%;其他椎体骨折发生率为9.1%。随访2年时:疼痛目测类比评分较治疗前明显改善(P<0.001);骨水泥位偏左侧5例,位于中部9例,偏右侧8例,疼痛改善程度与骨水泥位置无相关性(P=0.192);治疗后伤椎前、中缘高度较治疗前明显恢复(P<0.05);注入骨水泥的量1～5mL,注入骨水泥量与疼痛目测类比评分无相关性。表明单侧经皮椎体后凸成形治疗骨质疏松性椎体压缩骨折安全有效,骨水泥注入椎体内的位置、注入量与止痛效果无相关性。

BACKGROUND： Percutaneous kyphoplasty with polymethylmethacrylate bone cement in the treatment of osteoporotic vertebra compression fractures is effective and rapid in pain relief. OBJECTIVE： To evaluate the effectiveness of unipedicular percutaneous kyphoplasty with polymethylmethacrylate bone cement in the treatment of OVCFs. METHODS： Twenty-two cases of fresh osteoporotic vertebra compression fractures were performed unipedicular percutaneous kyphoplasty with polymethylmethacrylate bone cement. Their clinical data were analyzed retrospectively. RESULTS AND CONCLUSION： The mean follow-up time for the 22 cases was 2.5 years. Of all the cases, the leakage percentage was 4.5% and new vertebra fractures incidence was 9.1%. At 2 years postoperatively, Visual Analogue Scale scores were significantly improved than those preoperatively （P 〈 0.001）; in terms of the location of bone cement, five cases were on the left side, and nine cases were in the middle as well as eight cases were on the right side. There was no correlation between pain relief and the location of bone cement （P=0.192）. The anterior vertebral and middle margin height was significantly recovered postoperatively （P 〈 0.05）. The amount of bone cement was 1 5 mL. There was no correlation between the insertion amount of bone cement and Visual Analogue Scale scores during the 2-year follow-up. These findings suggest that unipedicular percutaneous kyphoplasty is safe and effective in pain relief, however, the insertion site and the amount of bone cement has no influence on pain relief.