PVP术骨水泥形态类型与术后伤椎高度丢失的关系研究

Relation between Bone Cement Dispersion Type and Fractured Vertebral Height Loss after Percutaneous Vertebroplasty

目的研究经皮椎体成形术骨水泥形态类型与术后病椎高度丢失的关系。方法回顾性分析2012年6月—2016年6月行经皮椎体成形术治疗的79例单一节段骨质疏松性椎体压缩性骨折老年患者的临床资料,根据术后脊柱正侧位X片和CT检查判断骨水泥在病椎内的形态分布可分为骨水泥团块组30例,平均年龄(79.5±8.6)岁和骨水泥弥散组49例,平均年龄(76.0±8.8)岁,比较2组患者病椎高度压缩率、骨水泥灌注量、手术时间、术后病椎高度恢复率、术后6个月病椎高度丢失率、术后矢状位Cobb角和骨水泥渗漏率等指标。结果 2组患者的年龄、性别、体质指数、术前血清钙、磷、碱性磷酸酶水平、骨密度值、术后病椎高度恢复率和术后矢状面Cobb角等指标差异无统计学意义(P>0.05),但术前病椎高度压缩率与术后椎体高度丢失率方面骨水泥弥散组小于团块组,差异有统计学意义(P<0.05)。结论骨水泥团块状分布类型可能是影响术后病椎高度丢失的重要危险因素之一。

Objective To investigate the relationship between bone cement dispersion types and fractured vertebral height loss after percutaneous vertebroplasty(PVP). Methods A retrospective analysis was made to the clinical data of 79 elderly patients with single segment vertebral compression fracture undergoing PVP during the period from June 1, 2012 to June 1, 2016;according to the X-ray radiographs and CT scans, all subjects were divided into 2 groups: mass type group [n=30, average age:(79.5±8.6) years] and diffusion type group [n=49, average age:(76.0±8.8) years]; the fractured vertebral height compression rate, the volume of bone cement filled, the operation time length, the fractured vertebral height restoration rate,6-month postoperative vertebral height loss rate, the postoperative local Cobb angle and bone cement leakage rate in the 2 groups were recorded respectively and a comparative study was made. Results There was no significant difference in age, sex, body mass index, the levels of serum calcium and phosphorus, bone mineral density, fractured vertebral height restoration rate and postoperative local Cobb angle between the 2 groups(P>0.05) while the preoperative fractured vertebral height compression rate and postoperative vertebral height loss rate in diffusion type group were significantly lower than those in mass type group(P<0.05). Conclusions Bone cement mass dispersion maybe an important risk factor for fractured vertebral height loss after PVP.