骨水泥弥散范围对单侧穿刺PVP术治疗骨质疏松性椎体压缩性骨折疗效的影响

Effect of bone cement in the treatment of osteoporotic vertebral compression fractures with different dispersion range of PVP

目的探讨单侧穿刺PVP手术过程中,骨水泥的偏向分布与否对骨质疏松性椎体压缩性骨折(Osteoporotic vertebral compression fractures,OVCF)疗效的影响。方法回顾性分析了2012-03-2014-09收治的103例OVCF患者,均采用单侧穿刺PVP手术治疗,依据其X线正位片的骨水泥弥散情况(骨水泥是否弥散过椎体中线对称分布),分为过中线组(75例)与未过中线组(28例),探讨两组患者术后的相关指标。结果两组术后的VAS与ODI评分改善方面,均取得相似的疗效(P>0.05)。但与过中线组比较,未过中线组的伤椎再塌陷发生率更高(25.0%VS 13.3%),骨水泥渗漏发生率更低(14.3%VS 26.7%),差异均有统计学意义(P<0.05)。结论单侧PVP手术过程中,骨水泥的偏向分布与否对疗效本身并无显著影响,但增加了术椎再塌陷的风险;术中若追求骨水泥的对称性分布,应注意防止骨水泥渗漏的发生。

Objective 3,0 investigate the influence of skewed distribution of bone cement on efficacy of PVP unilateral puncture in the treatment of osteoporotic vertetu＇al compression fractures （OVCF）. Methods From March 2012 to September 2014, the clinical data of 103 OVCF patients who received PVP unilateral puncture surgical treatment were retrospectively analyzed. According to the bone cement dispersion X-ray radiographs （bone cement dispersion over whether the vertebral midline symmetry）, the patients were divided into the midline group （75 cases） and not over the midline group （28 cases）. The postoperative indicators of two groups were analyzed. Results The improvements of VAS and ODI scores in two groups were similar （P〉0.05）. However, compared with the midline group, the incidence rate of vertebral collapse in not over the midline group was higher （25% vs 13.3%）, and the incidence rate of bone cement leakage was lower （14.3% vs 26.7%）, the difference was statistically significant（P〈0.05）. Conclusion The unilateral PVP bias during the surgery, bone cement distribution and the effect itself has no significant effect, but increased the risk of vertehral collapsc; in operation if the pursuit of bone cement symmelry distribution, shouht pay attention to prevent the occurrence of leakage of bone cement.