高黏度骨水泥单侧PVP治疗>70岁老年单椎体骨质疏松性压缩骨折的有效性与安全性

Efficacy and safety of unilateral percutaneous vertbroplasty with high viscosity bone cement in patients aged 70 years and over with one-level osteoporotic vertebral compression fracture

目的分析高黏度骨水泥单侧经皮椎体成形术(PVP)治疗>70岁老年单椎体骨质疏松性压缩骨折的有效性与安全性。方法收集医院2015年1月至2016年6月收治的>70岁的老年单椎体骨质疏松性压缩骨折病人65例,对其临床资料进行回顾性分析。根据不同术式分为2组,对照组32例行经皮椎体后凸成形术(PKP)联合低黏度骨水泥治疗,观察组33例行单侧PVP联合高黏度骨水泥治疗。比较2组病人的手术情况、视觉模拟评分(VAS)、oswestry功能障碍指数(ODI)、伤椎椎体前缘高度、椎体后凸Cobb角变化及骨水泥渗漏等并发症的发生情况。结果观察组手术时间、透视次数以及骨水泥注入量均明显低于对照组,差异均有统计学意义(P<0.05);术后1 d、12个月,2组病人ODI指数、VAS评分比较差异均无统计学意义(P>0.05);术后12个月,2组病人伤椎椎体前缘高度、椎体后凸Cobb角比较差异均无统计学意义(P>0.05);观察组骨水泥渗漏率为9.09%,明显低于对照组的28.13%,差异有统计学意义(P<0.05)。结论单侧PVP联合高黏度骨水泥与PKP联合低黏度骨水泥均是治疗>70岁老年单椎体骨质疏松性压缩骨折的有效方案,前者提高了手术的安全性,且明显减少了骨水泥渗漏,值得临床推广。

Objective To analyze the efficacy and safety of unilateral percutaneous vertebroplasty （PVP） With high viscosity bone cement for patients with one-level osteoporotic vertebral compression fracture in the elderly patients aged 70 years and over. Methods Sixty-five patients aged 70 years and over with one-level osteoporotic vertebral compression fracture in our hospital from January 2015 to June 2016 were collected, and the clinical data of the patients were analyzed retrospectively. The patients were divided into two groups according to different surgical procedures, the control group（ n = 32） treated with percutaneous kyphoplasty （ PKP ） with low viscosity bone cement, the observation group （ n = 33 ） treated with unilateral PVP with high viscosity bone cement. The time of operation, visual analogue scale （ VAS）, Oswestry disablitiy index （ ODI）, anterior vertebral height, anterior vertebral Cobb angle and the incidence rate of leakage of bone cement were compared between the two groups. Results The operation time, fluoroscopy times and the amount of bone cement injection in the observation group were significantly lower than those in the control group（P〈0. 05） ; 1 d and 12 months after operation, there were no significant difference in ODI and VAS scores between the two groups（P〉0. 05） ;12 months after operation, there were no significant difference in the anterior vertebral height and anterior vertebral Cobb angle（P^0. 05） between the two groups; The incidence rate of bone cement leakage in the observation group was 9.09%, which was lower than that of 28. 13% in the control group（P〈0.05）. Conclusions Unilateral PVP with high viscosity bone cement and PKP with low viscosity bone cement are effective schemes for patients with one-level osteoporotic vertebral compression fracture aged 70 years and over, but the former improves the safety of surgery, and obviously reduces the bone cement leakage.