高粘度骨水泥椎体成形术与球囊扩张椎体成形术治疗骨质疏松性椎体压缩骨折疗效对比分析

Effect Comparison between Vertebroplasty using High Viscosity Bone Cement and Balloon Kyphoplasty in Treatment of Patients with Osteoporotic Vertebral Body Crush Fracture

目的探讨高粘度骨水泥椎体成形术及球囊扩张椎体成形术治疗骨质疏松性椎体压缩骨折疗效的差异性。方法回顾性分析于2012年12月—2014年12月我院诊断为骨质疏松性椎体压缩骨折的患者106例,其中52例行高粘度骨水泥椎体成形术(A组),54例行球囊扩张椎体成形术(B组),通过对比两组患者的疼痛强度视觉类比评分、椎体高度恢复率、椎体后凸Cobb角矫正率、骨水泥渗漏率及手术操作时间来评价手术疗效。结果两组术后3 d和末次随访时的椎体高度高于术前、椎体后凸Cobb角及疼痛强度视觉类比评分均低于术前(P<0.05)。两组之间椎体高度恢复率、椎体后凸Cobb角矫正率及骨水泥渗漏率之间差异无统计学意义(P>0.05),但高粘度骨水泥椎体成形术操作时间较球囊扩张椎体成形术短(P<0.05)。结论采用高粘度椎体成形系统在患者疼痛症状缓解、椎体高度恢复、后凸畸形矫正及骨水泥渗漏方面与传统球囊扩张椎体成形术效果相同,但手术时间明显缩短,对骨质疏松性压缩骨折患者是一种积极有效的治疗方法。

Objective To compare clinical effect between vertebroplasty using high viscosity bone cement and balloon kyphoplasty in treatment of patients with osteoporotic vertebral body crush fracture. Methods Clinical data of106 patients with osteoporotic vertebral body crush fracture during December 2012 and December 2014 was retrospectively analyzed,and then 52 patients underwent vertebroplasty using high viscosity bone cement（ group A） and 54 patients underwent balloon kyphoplasty（ group B）. Clinical effects were evaluated through comparing values of visual analog pain scores（ VSA）,recovery rate of vertebral body height,correction rate of Cobb angle,leakage rate of bone cement and operation time in two groups. Results Compared with those before surgery,values of vertebral body height were higher,while values of Cobb angle and VAS were significantly lower 3 d after surgery and during the latest follow-up of two groups（ P〈0. 05）. No significant differences were observed between two groups in recovery rate of vertebral body height,correction rate of Cobb angle and leakage rate of bone cement（ P〈0. 05）,but operation time of vertebroplasty high viscosity bone cement was significantly shorter than that of balloon kyphoplasty（ P〈0. 05）. Conclusion Compared with those by balloon kyphoplasty,vertebroplasty using high viscosity bone cement has similar effect in symptomatic relief of pain,recovery of vertebral body height,deformity correction and leakage of bone cement in treatment of patients with osteoporotic vertebral body crush fracture,but it can significantly reduce operative time.