不同剂量骨水泥注入在单侧经皮椎体成形术治疗骨质疏松性压缩性骨折中的应用效果

Applicative effect of different doses of bone cement injection in the unilateral percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures

目的探讨不同剂量骨水泥注入在单侧经皮椎体成形术(PVP)治疗骨质疏松性压缩性骨折(OVCF)中的临床应用效果。方法选取2015年2月～2016年12月沈阳市骨科医院收治的OVCF患者113例为研究对象。根据随机数字表法将患者分为对照组(n=57)和研究组(n=56)。对照组患者行PVP术式时给予2.6～3.5 mL骨水泥,研究组则给予1.5～2.5 mL骨水泥。比较两组患者术前、术后1个月、术后6个月疼痛状态、运动功能、Cobb角、伤椎椎体前缘高度比以及骨水泥渗漏情况,同时观察其他并发症的发生情况。结果两组患者术后1、6个月的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)量表评分均低于术前(P <0.05),但两组患者术后各观察时间点组间比较差异无统计学意义(P> 0.05)。两组患者术后1、6个月的Cobb角较术前减小(P <0.05),但组间比较差异无统计学意义(P> 0.05);两组患者术后1、6个月椎体前缘高度比较术前显著增加,且研究组低于对照组(P <0.05)。研究组患者总渗漏率为7.14%(4/56),显著低于对照组的29.82%(17/57)(P <0.05)。两组术后其他并发症发生率比较差异无统计学意义(P> 0.05)。结论 PVP术式治疗OVCF患者,1.5～2.5 mL、2.6～3.5 m L两种不同剂量的骨水泥均可有效改善患者临床症状,减轻患者疼痛,但小剂量的骨水泥可降低其渗漏率。

Objective To investigate the applicative effect of different doses of bone cement injection in the unilateral percutaneous vertebroplasty(PVP)for treatment of osteoporotic vertebral compression fractures(OVCF).Methods One hundred and thirteen patients with OVCF in Shenyang Orthopedics Hospital from February 2015 to December 2016 were selected as research objects.According to random number table method,the patients were divided into control group(n=57)and study group(n=56).The control group was given 2.6-3.5 mL of bone cement for PVP,and the study group was given 1.5-2.5 mL of bone cement.The pain state,motor function,Cobb angle,the height ratio of vertebral body front edge and the leakage of bone cement was compared between the two groups before operation and 1 month,6 months after operation,and the occurrence of other complications was observed.Results The scores of visual analogue scale(VAS)and Oswestry disability index(ODI)in different observation time was lower than those before operation in two groups(P<0.05),but there was no significant difference between the two groups at 1 month,6 months after operation(P>0.05).The Cobb angle of the two groups 1 month and 6 months after the operation was decreased(P<0.05),but there was no significant difference between the two groups(P>0.05).The height ratio of vertebral body front edge of two groups was significantly increased 1 month and 6 months after operation,and the control group was higher than that of the study group(P<0.05).The total leakage rate of the study group was 7.14%(4/56),which was significantly lower than that of the control group(29.82%,17/57)(P<0.05).There was no significant difference in the incidence of complications after operation between the two groups(P>0.05).Conclusion The two different doses of bone cement injection(1.5-2.5 mL and 2.6-3.5 mL)in the PVP for treatment of OVCF can effectively improve the clinical symptoms and reduce the pain in patients,but the low dose of bone cement can reduce the rate of leakage.