改良定向骨水泥推注器预防经皮椎体成形术中骨水泥渗漏

Modifi ed oriented bone cement injector preventing cement leakage in percutaneous vertebroplasty

目的对传统骨水泥推注器进行改良,实现骨水泥的定向灌注,并探讨其在经皮椎体成形术(PVP)中对骨水泥渗漏的预防作用。方法 2013年6月—2015年6月共收治骨质疏松性椎体压缩骨折(OVCF)患者153例(182个椎体),其中73例患者(88个椎体)采用改良定向骨水泥推注器(改良组),80例患者(94个椎体)采用传统骨水泥推注器(对照组),两组患者年龄、性别比、骨密度、术前疼痛视觉模拟量表(VAS)评分、骨折压缩程度等差异均无统计学意义。比较两组患者术中骨水泥渗漏情况和术后3 d、6个月时的VAS评分。结果所有患者手术均顺利完成。改良组术中有7个椎体出现骨水泥渗漏,其中C型5例,S型2例;对照组术中有29个椎体发生骨水泥渗漏,其中C型19例,B型1例,S型9例。改良组骨水泥渗漏率低于对照组,差异具有统计学意义(P<0.05)。两组患者术后3 d、6个月时的VAS评分均高于术前,差异具有统计学意义(P<0.05),但组间差异无统计学意义。结论在PVP中使用改良定向骨水泥推注器能明显降低骨水泥的渗漏率。

Objective To modify the oriented cement injector and investigate the prevention effect of the new injector on the bone cement leakage in percutaneous vertebroplasty（PVP）. Methods From June 2013 to March 2015,153 patients with osteoporotic vertebral compression fracture were treated with PVP. Seventy-three patients with 88 fractured vertebrae underwent PVP by modified cement injector（modified group）,and 80 patients with 90 fractured vertebrae received PVP by conventional cement injector（control group）. There were no significant differences between 2 groups in age,sex,bone density,preoperative Visual Analogue Scale（VAS） score and degree of vertebral compression. Results All the patients recovered well. In the modified group,there were 7 cement leakages,type C was noted in 5 vertebrae,type S in 2;In the control group,there were 29 leakages,type C in 19 vertebrae,type B in 1 vertebra,and type S in 9 vertebrae. There was a significant difference in the rate of cement leakage between 2 groups（P〈0.05）. The VAS scores showed significant differences between pre-operation and both postoperative 3 d and 6 months in both groups（P〈0.05）,but no significant intergroup differences. Conclusion The modified oriented bone cement injector can significantly reduce the rate of cement leakage in PVP.