经皮治疗有无裂隙骨质疏松椎体压缩骨折骨水泥分布及渗漏率比较

An evaluation of cement distribution patterns and cement leakage after percutaneous vertebroplasty for osteoporotic vertebral compression fractures with and without intravertebral vacuum cleft

目的比较经皮椎体成形术(PVP)治疗有无椎体内真空裂隙(IVC)的骨质疏松椎体压缩骨折(OVCFs)在骨水泥渗漏的差异。方法回顾性分析284例PVP治疗单节段OVCFs符合纳入标准的患者资料,其中IVC组104例,无IVC组180例。术后所有患者均行X线和CT检查,以评估骨水泥在伤椎内填充形式、有无骨水泥渗漏及渗漏部位,比较两组差异有无统计学意义。结果在IVC组104例患者中,以局限实体团块填充为68例(65.4%),与骨小梁相互嵌插填充为36例;无IVC组180例患者中,以局限实体团块填充为44例,与骨小梁相互嵌插填充为136例(75.6%),两组间比较差异有统计学意义(P<0.01)。IVC组有18例(17.3%)、无IVC组有30例(16.7%)发生骨水泥渗漏,组间差异无统计学意义(P>0.05)。IVC组最常见临近椎间盘渗漏,共10例(66.7%);无IVC组最常见椎前或椎旁静脉渗漏,共22例(73.3%),两组间比较差异有统计学意义(P<0.05)。结论 PVP治疗有无IVC的OVCFs在骨水泥渗漏率是类似的,但在骨水泥渗漏部位具有明显差异。

Objective To compare the difference of polymethylmethacrylate （PMMA） leakage after percutaneous vertebroplasty （PVP） for osteoporotie vertebral compression fractures （OVCFs） with and without intravertebral vacuum cleft （IVC）. Methods In total, 284 patients treated for single - OVCF, among whom 104 patients were enrolled in IVC group and 180 patients in non - IVC group, were retrospectively reviewed. The follow - up period was at least 2 years. Plain X -rays and CT were postoperatively performed to investigate PMMA distribution pattern within the affected vertebrae, the presence of PMMA leakage and leakage types. Furthermore, the difference between two groups was compared. Results The local solid lump distribution pattern accounted for 65.4% in IVC group and 24.4% in non - IVC group. The PMMA leakage occurred in 18 （ 18/104, 17.3% ） patients in IVC group and 30 （30/180, 16.7% ） patients in non - IVC group, without significant difference （P 〉 0.05 ）. The leakage types that frequently occurred were intradiscal （12/ 18, 66.7% ） in IVC group and perivertebral venous （22/30, 73.3% ） in non- IVC group. A significant difference was found in leakage type between the 2 groups. Conclusion The incidences of PMMA leakage in osteoporotic compression fractures with and without IVCs were similar. However, leakage type differs.