高黏度骨水泥经皮椎体成形术对绝经骨质疏松压缩骨折的疗效评价

Efficacy evaluation of high viscosity bone cement percutaneous vertebroplasty on the treatment of postmenopausal osteoporotic compression fractures

目的:评价高黏度骨水泥经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗绝经骨质疏松压缩骨折的临床疗效,为该病的临床治疗方案选择提供参考依据。方法:以我院2010年4月至2012年4月收治的170例绝经骨质疏松性压缩骨折患者为研究对象,按照随机数字表分为观察组、对照组,各85例,均实施PVP治疗,观察组术中应用高黏度骨水泥,对照组术中应用低黏度骨水泥。比较两组患者疼痛、功能、影像学指标变化及术后骨水泥渗漏发生情况,探讨高黏度骨水泥对治疗效果与安全性的影响。结果:两组患者术后视觉模拟评分(visual analogue scale,VAS)均较术前下降,观察组术后15 d、术后3个月VAS评分低于对照组,差异有统计学意义(P<0.05)。两组患者术后Oswestry功能障碍指数问卷表(Oswestry disability index,ODI)评分均较术前降低,日本骨科协会评估治疗分数(Japanese Orthopaedic Association Scores,JOA)评分均升高,观察组术后6个月ODI评分低于对照组,其JOA评分高于对照组,差异有统计学意义(P<0.05)。两组患者术后椎体高度压缩率、椎体后凸Cobb角均较术前下降,观察组术后椎体高度压缩率、椎体后凸Cobb角低于对照组,其椎体高度恢复率高于对照组,差异有统计学意义(P<0.05)。观察组术后骨水泥渗漏发生率为13.41%,低于对照组的51.85%,差异有统计学意义(P<0.05)。结论:PVP术中应用高黏度骨水泥能够明显降低绝经骨质疏松性压缩骨折患者术后骨水泥渗漏风险,对患者疼痛的早期缓解及机体功能的早期恢复均具有积极意义,值得推广。

Objective： To evaluate the clinical effcacy of high viscosity bone cement percutaneous vertebroplasty （PVP） on postmenopausal osteoporosis compression fractures, to provide reference for the selection of clinical treatment of the disease.Methods： 170 cases of postmenopausal osteoporotic compression fracture patients from April 2010 to April 2012 were selected as the research object, and divided into the observation group and the control group according to the random number table, with 85 cases in each. PVP treatment was carried out for all the patients. High viscosity bone cement was used in observation group, and control group with low viscosity bone cement. The changes of pain, function, imaging indexes and the incidence of bone cement leakage after operation was compared between the two groups. hTe effect of high viscosity bone cement on the treatment effect and safety was discussed.Results： Atfer operation, the visual analogue scale （VAS） scores of the two groups were lower than that before operation. In observation group, 15 d and 3 months atfer the operation, the VAS score was lower than that in the control group, the difference was statistically signiifcant （P〈0.05）. hTe postoperative Oswestry disability index （ODI） scores of the two groups were lower than before, and the JOA score increased. hTe ODI score of the observation group was lower than that of the control group atfer 6 months. hTe Japanese Orthopaedic Association Scores （JOA） score was higher than that in the control group, the difference was statistically signiifcant （P〈0.05）. In the two groups of patients, postoperative vertebral compression rate and vertebral kyphosis Cobb angle were lower than before operation. In observation group postoperative vertebral compression rate, vertebral kyphosis Cobb angle was lower than that of the control group, and vertebral body height recovery rate higher than that of the control group, the difference is statistically signiifcant （P〈0.05）. hTe incidence of postoperative bone cement leakage was 13.41% in the observation group and 51.85% in the control group, the difference was statistically signiifcant （P〈0.05）.Conclusion： hTe application of high viscosity bone cement in PVP can signiifcantly reduce postoperative postmenopausal osteoporotic compression fractures in patients with bone cement leakage risk. It is of positive signiifcance to ease the pain in patients with early and physical function of early recovery and is worthy to be popularized.