MSCT容积测量在两种椎体成型术后评价中的应用

Application of MSCT volume measurement in the postoperative evaluation of percutaneous vertebroplasty and kyphoplasty

目的探讨MSCT(螺旋CT)容积重建技术在评价椎体成型术(PVP)及椎体后凸成型术(PKP)治疗椎体压缩骨折疗效中的应用。方法回顾性分析2007年12月至2012年12月到我院就诊的34例骨质疏松导致椎体压缩骨折的患者,分别进行了PVP及PKP椎体成形术,术后72小时内进行MSCT检查,通过MSCT容积测量,得到注入骨水泥的量及其弥散体积,计算得出其弥散系数。两种手术方式组间骨水泥弥散系数的差异、两组间VAS评分变化(术前-术后)的差异采用两独立样本t检验,比较两组骨水泥弥散系数及VAS评分变化的差异。骨水泥弥散系数与VAS评分变化的关系采用spearman相关分析。结果两种手术方式组间骨水泥弥散系数的差异有统计学意义(P=0.005)。两组间VAS评分变化(术前-术后)的差异有统计学意义(P=0.026)。骨水泥弥散系数与VAS评分变化存在一定的相关关系(r=0.465)。结论 PVP骨水泥弥散系数小于PKP。骨水泥弥散系数可以作为评价椎体成形术疗效的参考指标。

Objective To analyzed the application of MSCT volume measurement in comparing the effects of percutaneous vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures.Methods Retrospective data of 34 patients with osteoporotic vertebral compression fractures were analyzed in our hospital during December 2007 to December 2012.The patients were treated by percutaneous vertebroplasty and kyphoplasty,and received MSCT examination within 72 hour after operation..By the CT volume measurement,the dispersion coefficient was calculated by the volume of bone cement introduced and dispersion volume..The differences of the dispersion coefficient and VAS scores.（preoperative minus the postoperative）.between two groups that treated by PVP or PKP were performed Independent-Samples T Test,and the difference of the bone cement dispersion coefficient and VAS scores between two groups was compared..The relationship between the bone cement dispersion coefficient and VAS score changes were analyzed by Spearman Correlation Analysis.Results The bone cement dispersion coefficient between two groups of different operation method was statistically significant.（P=0.005）.The differences of VAS scores between two groups was statistically significant（P =0.026）.The relationship between the bone cement dispersion coefficient and VAS scores were certain relationship.（r =0.465）..Conclusion The bone cement dispersion coefficient of PVP is less than PKP.Bone cement dispersion coefficient can be used as a reference indicator of evaluating the effect of vertebral plasty.