单侧穿刺椎体成形术中骨水泥不同弥散范围对疗效的影响

Effect of cement distribution in unilateral approach vertebroplasty

目的探讨单侧穿刺椎体成形术中骨水泥不同弥散范围对疗效的影响。方法按照X线正位片上骨水泥弥散是否过椎体中线呈对称分布,将74例单椎体压缩不超过50%的楔形骨折接受单侧穿刺椎体成形术的患者分为未过椎体中线组（26例）和过椎体中线组（48例）。比较两组患者的年龄、骨折压缩程度、手术时间、住院时间、骨水泥量、骨水泥渗漏率、术前及术后疼痛VAS评分以及术后再骨折率。结果患者均获得随访,时间6-27（13.7±3.7）个月。两组疼痛VAS评分术后3 d及3个月均较术前明显改善,差异有统计学意义（P〈0.05）,两组之间比较差异无统计学意义（P〉0.05）。两组患者的年龄、骨折压缩程度、手术时间、住院时间、骨水泥量、骨水泥渗漏率及术后再骨折率比较差异均无统计学意义（P〉0.05）。结论对于压缩不超过50%的楔形椎体骨折,单侧穿刺椎体成形术中的骨水泥不同弥散范围不影响疗效。

Objective To investigate effect of different cement distribution on the treatment of vertebral compression fractures by unilateral approach vertebroplasty. Methods A retrospective analysis of 74 patients with single vertebral compression fracture（ no more than 50% compression） who underwent unilateral approach vertebroplasty was conducted. The patients were divided into not across the midline of the vertebral body group（ 26 cases） and across the midline of the vertebral body group（ 48 cases） by the distribution of bone cement in the anterior-posterior X-ray film.The pre- and post-operative VAS,age,compression degree of fracture,operative time,length of hospital stay,bone cement volume,bone cement leakage rate and postoperative refracture rate were compared in the two groups. Results All patients were followed up for 6 - 27（ 13. 7 ± 3. 7） months. In both groups,the VAS at 3d and 3 months after the surgery were lower,compared to the preoperative scores（ P〈0. 05）. And the VAS at 3d and 3 months after the surgery had no statistical differences between the two groups（ P〉0. 05）. The patients age,compression degree of fracture,operative time,length of hospital stay,bone cement,bone cement leakage rate and postoperative refracture rate were all not comparable between the two groups（ P〈0. 05）. Conclusions Different distribution of bone cement in the unilateral approach vertebroplasty maybe not affect the treatment of vertebral farctures with no more than 50%compression.