不同黏度骨水泥治疗骨质疏松性椎体压缩性骨折疗效比较

Comparison of Different Viscosity Bone Cement in the Treatment of Osteoporotic Vertebral Compression

目的:探讨不同黏度骨水泥治疗骨质疏松性椎体压缩性骨折的临床疗效。方法:选择2016年1月~2018年6月滁州市第一人民医院收治的骨质疏松性椎体压缩性骨折患者90例,按照随机数字表法分为高黏度组42例和低黏度组48例,分别采用高黏度骨水泥经皮椎体后凸成形术和低黏度骨水泥经皮椎体后凸成形术治疗。比较两组单个椎体手术时间、骨水泥注入量、骨水泥渗漏发生情况。所有患者术后随访3个月,比较两组术前、术后3个月疼痛数字评分量表(NRS)评分、Oswestry功能(ODI)评分、椎体中间高度和Cobb角变化。结果:高黏度组单个椎体手术时间少于低黏度组(P<0.05),两组骨水泥注入量、骨水泥弥散体积比较无统计学差异(P>0.05)。高黏度组骨水泥总渗漏率低于低黏度组(P<0.05)。两组患者术前NRS评分、ODI评分、椎体中间高度和Cobb角比较差异无统计学意义(P>0.05);术后3个月两组NRS评分、ODI评分和Cobb角较术前降低,椎体中间高度较术前升高,且高黏度组NRS评分、ODI评分和Cobb角低于低黏度组,椎体中间高度高于低黏度组(P<0.05)。结论:高黏度骨水泥经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效较低黏度骨水泥更佳,术后总渗漏率更低,脊柱畸形矫正、脊柱功能恢复更佳,同时疼痛也明显降低,适于临床推广。

Objective: To explore the clinical effect of different viscosities bone cement in the treatment of osteoporotic vertebral compression fractures. Methods: 90 patients with osteoporotic vertebral compression fractures who were treated in The First People’s Hospital of Chuzhou from January 2016 to June 2018 were selected, they were divided into high viscosity group(42 cases) and low viscosity group(48 cases) according to the method of digital random table. Percutaneous kyphoplasty with high-viscosity bone cement and percutaneous kyphoplasty with low-viscosity bone cement were used respectively. The operation time, cement injection volume and bone cement leakage of two groups were compared. All patients were followed up for 3 months. The changes of NRS score, Oswestry function(ODI) score, vertebral height and Cobb angle before and after operation were compared between the two groups. Results: The operation time of single vertebral body in the high viscosity group was less than that in the low viscosity group(P<0.05). There was no significant difference between the two groups in the bone cement injection volume and the bone cement dispersion volume(P>0.05). The total bone cement leakage rate of high viscosity group was significantly lower than that of low viscosity group, there were statistical differences between the two groups(P<0.05). There were no significant differences in preoperative NRS score, ODI score, intervertebral height and Cobb angle between the two groups(P>0.05). The NRS score, ODI score and Cobb angle of the two groups at 3 months after operation were lower than those before operation, the intervertebral height was higher than that before operation. The NRS score, ODI score and Cobb angle of the high viscosity group were lower than those of the low viscosity group, The intervertebral height was higher than that of low viscosity group(P<0.05). Conclusion: Percutaneous kyphoplasty with high-viscous bone cement is better than percutaneous kyphoplasty with low-viscous bone cement. The total leakage rate is lower, spinal deformity correction and spinal function recovery is better,while the pain is also significantly reduced, which is suitable for clinical promotion.