PVP术中采用不同类型骨水泥治疗严重OVCF的效果及安全性

Effect and safety of PVP with different types of bone cement in the treatment of severe OVCF

目的探讨低粘度和高粘度骨水泥行经皮椎体成形术(PVP)治疗严重骨质疏松性椎体压缩性骨折(OVCF)的效果及安全性。方法将我院收治的行PVP术的114例严重OVCF患者以随机数字表法分为对照组(低粘度骨水泥)和观察组(高粘度骨水泥),各57例。比较两组患者的治疗效果及安全性。结果手术后12个月,两组VAS评分、ODI评分均降低,SF-36评分均升高(P<0.05);但两组间无显著差异(P>0.05)。手术后12个月,两组的后凸Cobb角均减小,且观察组后凸Cobb角、伤椎高度恢复率优于对照组(P<0.05)。两组骨水泥注入量无显著差异(P>0.05)。观察组骨水泥总渗漏率低于对照组(P<0.05)。结论 PVP术中采用不同类型骨水泥治疗严重OVCF在减轻患者疼痛程度、改善腰背活动度及提高生活质量方面效果接近。但高粘度骨水泥的应用更有利于促进伤椎恢复,预防骨水泥渗漏。

Objective To investigate the effect and safety of percutaneous vertebroplasty(PVP)with low and high viscosity bone cement in the treatment of severe osteoporotic vertebral compression fractures(OVCF).Methods A total of 114 patients with severe OVCF who underwent PVP in our hospital were divided into control group(low viscosity bone cement)and observation group(high viscosity bone cement),with 57 cases in each group.The therapeutic effect and safety of the two groups were compared.Results At 12 months after operation,the scores of VAS and ODI of the two groups decreased,and the scores of SF-36 increased(P<0.05),but there were no significant differences between the two groups(P >0.05).At 12 months after operation,the Cobb angle of kyphosis of the two groups decreased,while the Cobb angle of kyphosis and the recovery rate of vertebral height were better than those in the control group(P<0.05).There was no significant difference in the amount of bone cement injected between the two groups(P >0.05).The total leakage rate of bone cement in the observation group was lower than that in the control group(P<0.05).Conclusion Different types of bone cement used in PVP for severe OVCF have similar effects in alleviating pain,improving of lumbar and dorsal mobility and quality of life of patients.However,the application of high viscosity bone cement is more conducive to promoting the recovery of injured vertebrae and preventing the leakage of bone cement.