高粘度联合夯实技术在PKP治疗骨质疏松性椎体压缩性骨折中的临床效果观察

Clinical effect observation of high viscosity combined with compaction technique on the treatment of patients with osteoporotic vertebral compression fractures by percutaneous kyphoplasty

目的探讨高粘度联合夯实技术应用于经皮球囊扩张椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩性骨折(OVCF)的疗效。方法回顾性分析80例骨质疏松性椎体压缩性骨折患者的临床资料。40例患者运用高粘度联合夯实技术应用于经皮球囊扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折,40例患者采用传统操作椎体后凸成形术治疗骨质疏松性椎体压缩性骨折,比较2组患者术中手术时间、骨水泥灌注量、骨水泥渗漏发生率、相邻椎体再骨折、术后伤椎高度增加、术后12个月伤椎高度丢失、手术前后椎体楔变角度、VAS疼痛评分、ODI脊柱评分等情况。结果 2组术前骨折椎体高度无显著差异(P>0.05),但2组术后伤椎高度增加、术后12个月伤椎高度丢失方面有显著差异(P<0.05);2组疼痛缓解和功能改善方面疗效无显著差异(P>0.05);2组骨水泥渗漏率、骨水泥注入量有显著差异(P<0.05);2组术后椎体楔变角度恢复效果比较有显著差异(P<0.05);2组相邻椎体再骨折、VAS疼痛评分、ODI脊柱评分方面无显著差异(P>0.05)。结论在椎体后凸成形术中应用高粘度骨水泥、夯实技术能缓解患者的疼痛,提高患者的生活质量。

Objective To explore the effect of high viscosity combined with compactiontechnique on the treatment of patients with osteoporotic vertebral compression fractures(OVCF)by percutaneous kyphoplasty(PKP).Medthods The clinical data of 80 patients with OVCF were retrospectively analyzed.Among them,40 patients with OVCF by PKP were treated with high viscosity and compaction technique,and 40 patients with OVCF were treated with traditional PKP.Operation time,the amount of bone cement perfusion,the incidence of bone cement leakage,the incidence of vertebral refracture,the height of vertebral body recovery after operation,the loss of vertebral height after 12 months,vertebral wedge angle before and after operation,VAS pain score,ODI score were compared between two groups.Results There was no significant difference in the height of fracture vertebral body between two groups(P>0.05),but there were significant differences in postoperative vertebral height increase,the loss of vertebral height after 12 months between two groups(P<0.05).There were no significant differences in pain relief and functional improvement effect between two groups(P>0.05),but there were significant differences in bone cement leakage rate and amount of bone cement injection between two groups(P<0.05).There was significant difference in recovery of postoperative vertebral wedge angle between two groups(P<0.05),but there were no significant differences in adjacent vertebral fractures,the VAS pain score and ODI spine score between two groups(P>0.05).Conclusion Application of high viscosity combined with compaction technique can relieve the painand improve the quality of life in patients with OVCF by PKP.