不同黏度骨水泥对骨质疏松性腰椎骨折患者PKP术后功能障碍的影响

Effects of bone cement of different viscosities on the post-PKP dysfunction of patients with osteoporotic lumbar vertebral fracture

目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty, PKP)术中注入不同黏度骨水泥对骨质疏松性腰椎骨折(osteoporotic lumbar vertebral fracture, OFLV)患者术后功能障碍的影响。方法选取100例OFLV患者,依据随机数字表法分为高度组和低度组,各50例。高度组PKP术中注入高黏度骨水泥,低度组注入低黏度骨水泥,比较两组患者椎体前缘高度、后凸Cobb角、疼痛、功能障碍和骨水泥渗漏情况。结果术后3 d、术后6个月,两组椎体前缘高度均高于术前、后凸Cobb角均低于术前,且术后3 d、术后6个月高度组的椎体前缘高度均高于低度组、后凸Cobb角均低于低度组,差异均有统计学意义(P<0.05);术后3 d、术后6个月,两组VAS和ODI评分低于术前,且术后3 d、术后6个月,高度组VAS和ODI评分均低于低度组,差异均有统计学意义(P<0.05);高度组骨水泥渗漏率(6.00%,3/50)低于低度组(20.00%,10/50),差异有统计学意义(χ~2=4.332,P=0.039)。结论与低黏度骨水泥比较,PKP术中注入高黏度骨水泥可更有效地恢复OFLV患者的椎体生理结构,改善患者的疼痛及功能障碍,且具有更好的安全性。

Objective To evaluate the effect of bone cement of different viscosities injected by percutaneous kyphoplasty(PKP) on postoperative dysfunction of patients with osteoporotic lumbar vertebral fracture(OFLV). Methods Firstly, 100 patients with OFLV were chosen as the subjects of study and divided into two groups, namely, high viscosity group(HVG)(n=50) and low viscosity group(LVG)(n=50) according to random number table method. High-viscosity bone cement was injected in the HVG group during PKP while low-viscosity bone cement was injected in the LVG group during PKP. The anterior height of vertebral body, kyphosis Cobb angle, pain, dysfunction and leakage of bone cement of the two groups were then compared. Results At three days and six months after operation, the height of anterior vertebral margin of both groups was higher than before operation. The Cobb angle of kyphosis of both groups was lower than before operation. The height of anterior vertebral margin in three days and six months after operation of the HVG was higher than that in the LVG group. The Cobb angle of kyphosis of the HVG group was lower than that in the low-grade group. The difference was statistically significant(P<0.05).Three days and six months after operation, the VAS and ODI scores of the two groups were lower than before operation. Three days and six months after operation, the VAS and ODI scores of the HVG group were lower than those of the LVG group. The difference was statistically significant(P<0.05). The leakage rate of bone cement in the HVG group(6.00%, 3/50) was lower than that of the LVG group(20.00%, 10/50). The difference was statistically significant(χ~2=4.332, P=0.039). Conclusions Compared with low-viscosity bone cement, the injection of high-viscosity bone cement during PKP can restore the vertebral physiological structure of patients with OFLV more effectively, improve the pain and dysfunction of patients, and engender better safety.