改良骨水泥推注套管治疗骨质疏松椎体压缩性骨折可减少骨水泥渗漏

A modified working tube can reduce bone cement leakage in the treatment of osteoporotic vertebral compression fracture

背景:椎体成形治疗骨质疏松性的椎体压缩性骨折的疗效显著,但存在骨水泥渗漏问题。目的:分析改良椎体成形骨水泥推注套管治疗胸腰椎骨质疏松性椎体压缩骨折的优势。方法:纳入121例胸腰椎骨质疏松性椎体压缩骨折患者,其中男49例,女72例,年龄62-90岁,分2组治疗:对照组62例进行传统的椎体成形骨水泥注射治疗;试验组59例进行改良的椎体成形骨水泥推注套管治疗,将传统骨水泥注射套管末端开口改为侧方开口,通过旋转套管达到控制骨水泥注射的方向。对比治疗前后的目测类比评分;治疗后1 d,通过X射线观察两组骨水泥渗漏情况。结果与结论:两组治疗后1 d、1个月的目测类比评分均较治疗前明显降低(P<0.05),但两组间不同时间的目测类比评分比较差异无显著性意义;两组共13例患者发生骨水泥渗漏,其中试验组3例,对照组10例,试验组骨水泥渗漏率低于对照组(4.6%,14.9%,P<0.05)。结果表明,应用改良椎体成形骨水泥推注套管治疗胸腰椎骨质疏松性椎体压缩骨折,可降低骨水泥渗漏的发生率。

BACKGROUND:Vertebroplasty is an effective treatment for osteoporotic vertebral compression fractures(OVCF),but it is nagged by bone cement leakage.OBJECTIVE:To summarize the clinical outcome of modified self-making working tube in percutaneous vertebroplasty(PVP)for treatment of thoracolumbar OVCF.METHODS:Modified PVP working tube was designed to have a lateral gap at the sleeve tail,which could control the cement diffuse direction though rotating the working tube.Totally 121 thoracolumbar OVCF patients were enrolled,including 49 males and 72 females,aged 62-90 years,and then divided into two groups:59 patients were treated with modified PVP in test group,and the other 62 patients experienced conventional PVP in control group.In the test group,a lateral gap instead of the conventional gap at the sleeve tail was made to control the direction of bone cement injection by rotating the sleeve.The visual analogue scale scores were compared before and after operation;radiographic examination was performed to detect bone cement leakage at 1 day postoperatively.RESULTS AND CONCLUSION:There were significant differences between the preoperative and postoperative visual analogue scale scores in the two groups(P<0.05),but there was no significant difference between the two groups.There were 3 cases of bone cement leakage in the test group and 10 cases of bone cement leakage in the control group.Modified PVP working tube had significant lower rate of bone cement leakage than traditional PVP(14.9%vs.4.6%,P<0.05).Therefore,the modified PVP working tube is an effective tool to decrease the incidence of bone cement leakage in the treatment of thoracolumbar OVCF.