高黏度骨水泥治疗骨质疏松性椎体压缩骨折的疗效

The outcomes of high-viscosity bone cement in percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures

目的观察经皮椎体成形术（PVP）中使用高黏度骨水泥治疗骨质疏松性椎体压缩骨折的疗效及并发症。方法对60例骨质疏松性椎体压缩骨折患者（98个椎体）采用高黏度骨水泥PVP治疗。观察手术前后腰痛VAS评分、脊椎功能障碍指数（ODI）、骨水泥渗漏及邻近椎体骨折等并发症发生率。结果 60例均获得随访,时间3-6（4.2±1.4）年。VAS评分由术前6-10（8.4±1.2）分降低到末次随访时0-3（0.7±0.8）分（P〈0.001）;ODI由术前45%-91%（63.7%±15.9%）降低到末次随访时2%-31%（8.4%±6.6%）（P〈0.001）。共8个椎体（8.2%）发生骨水泥静脉渗漏,6个椎体（6.1%）发生椎间盘渗漏,8个椎体（8.2%）发生椎旁渗漏,2例（3.3%）发生邻近椎体骨折。结论采用高黏度骨水泥行PVP治疗骨质疏松性椎体压缩骨折可获得满意的临床疗效,骨水泥渗漏率及邻近椎体骨折发生率均较低。

Objective To summarize the clinical,radiographic outcomes and complications of high-viscosity bone cement in percutaneous vertebroplasty（ PVP） for treatment of osteoporotic vertebral compression fractures. Methods Sixty patients（ 98 vertebraes） of osteoporotic vertebral compression fractures were treated by PVP using high viscosity bone cement. These data were recorded,including back pain VAS,Oswestry disability index（ ODI）,rate of bone cement（ venous leakage,discoidal leakage,paravertebral leakage）,adjacent vertebral fracture. Results All of 60 patients were followed up for 3 - 6（ 4. 2 ± 1. 4） years. The VAS reduced from 6 - 10（ 8. 4 ± 1. 2） points preoperatively to 0 - 3（ 0. 7 ± 0. 8） points at final follow-up（ P〈0. 001）; the ODI reduced from 45% - 91%（ 63. 7% ±15. 9%） preoperatively to 2% - 31%（ 8. 4% ± 6. 6%） at final follow-up（ P〈0. 001）. There were eight vertebraes（ 8. 2%） the occurrence of venous leakage of bone cement,6 vertebraes（ 6. 1%） disc leakage,eight vertebraes（ 8. 2%） paravertebral leakage,and 2 patients（ 3. 3%） the occurrence of adjacent vertebral fractures. Conclusions The osteoporotic vertebral compression fractures treated by PVP using high viscosity bone cement can achieve a satisfactory clinical outcomes,with a low rate of discoidal leak,paravertebral leak and adjacent vertebral fracture.