经皮椎体成形术应用不同黏度骨水泥治疗骨质疏松性椎体压缩骨折的效果比较

Comparison of effects on osteoporotic vertebral compression fractures by percutaneous vertebroplasty with different viscosity bone cement

目的比较经皮椎体成形术(PVP)应用不同黏度骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法选择滨州市中心医院2017年1月至12月治疗的94例OVCF患者,应用随机数字表法分为观察组和对照组,每组47例。入选者均接受PVP治疗,术中对照组应用中黏度骨水泥,观察组应用高黏度骨水泥。观察两组骨水泥用量、渗漏情况、再发椎体骨折发生情况及手术前后视觉模拟评分法(VAS)评分、后凸Cobb角、伤椎前缘高度。结果术前两组后凸Cobb角、伤椎前缘高度及手术前后VAS评分比较,差异未见统计学意义(P>0.05)。与对照组比较,观察组术后后凸Cobb角较小,伤椎前缘高度较高,差异有统计学意义(P<0.05)。两组骨水泥用量、再发椎体骨折发生率比较差异未见统计学意义(P>0.05)。观察组骨水泥渗漏率低于对照组,差异有统计学意义(P<0.05)。结论PVP术中应用高黏度骨水泥治疗OVCF止痛效果确切且可降低骨水泥渗漏率,矫正后凸畸形与伤椎高度。

Objective To compare the clinical efficacy of percutaneous vertebroplasty (PVP) with different types of viscosity bone cement on osteoporotic vertebral compression fracture (OVCF). Methods Ninety-four OVCF patients treated in Binzhou City Center Hospital from January to December of 2017 were selected and divided into observation group and control group by random number table method, with 47 cases in each group. All the selected patients were treated by PVP, while patients in control group were treated by medium-viscosity bone cement, and patients in observation group were treated by high-viscosity bone cement. The amount of bone cement, leakage, recurrence of vertebral fracture and visual analogue scale (VAS) score before and after surgery, Cobb angle of kyphosis, and the height of injured vertebral front edge were observed in the two groups. Results There was no statistically significant difference in Cobb angle of kyphosis, the height of injured vertebral front edge before treatment, and VAS score before and after treatment between the two groups (P>0.05). Compared with control group, the postoperative kyphosis Cobb angle in the observation group was remarkable smaller in observation group, and the height of injured vertebral front edge was significantly higher (P<0.05). There was no statistically significant difference between the two groups in the amount of bone cement and the incidence of secondary vertebral fractures (P>0.05). Compared with control group, the leakage rate of bone cement in observation group was lower, and the difference was statistically significant (P<0.05). Conclusions The application of high-viscosity bone cement in PVP for OVCF has great analgesic effect, and it is beneficial to reduction on bone cement leakage rate and correction of kyphosis deformity and injured vertebra height.