椎体静脉稀疏区注入骨水泥对PVP术中骨水泥渗漏的影响

Effect of Bone Cement Injection into Venous Sparse Area on the Bone Cement Leakage during PVP Operation

目的:探讨椎体静脉稀疏区注入骨水泥对骨质疏松椎体压缩性骨折患者行经皮穿刺椎体成形术(percutaneous vertebroplasty,PVP)术中骨水泥渗漏的影响。方法:选择西安交通大学第二附属医院2014年1月至2018年6月收治的61例骨质疏松椎体压缩性骨折患者,根据骨水泥注入区域的不同,将所有患者分为A组(30例)及B组(31例),A组骨水泥注入区域为椎体静脉密集区(椎体中1/3平面处),B组骨水泥注入区域为椎体静脉稀疏区(椎体上1/3及下1/3平面处),对比两组的骨水泥渗漏率,术前、术后6个月时的视觉模拟评分(Visual analogue scale,VAS),治疗中的骨水泥用量、椎体高度恢复率及cobb角恢复度数。结果:B组的骨水泥渗漏率及骨水泥用量均明显低于A组(P<0.05)。两组的VAS评分、椎体高度恢复率、cobb角恢复情况对比差异无统计学意义(P>0.05)。结论:与椎体静脉密集区相比,在椎体静脉稀疏区注入骨水泥可显著降低骨质疏松椎体压缩性骨折患者PVP术中骨水泥渗漏率,椎体静脉稀疏区可作为PVP术中骨水泥注射的一个相对安全区域。

Objective: To investigate the effect of bone cement injection on the leakage of bone cement in patients with osteoporotic vertebral compression fractures undergoing percutaneous vertebroplasty(PVP). Methods: 61 patients with osteoporotic vertebral compression fractures admitted to the Second Affiliated Hospital of Xi’an Jiaotong University from January 2014 to June 2018 were selected, all patients were divided into group A(30 cases) and group B(31 cases) according to the area of bone cement injection. Group A bone cement injection area is vertebral vein dense area(1/3 plane in vertebral body), group B bone cement injection area is vertebral vein sparse area(vertebrae 1/3 and lower 1/3 plane), comparing the cement leakage rate of the two groups, visual analogue scale(VAS) before and 6 months after surgery, the amount of bone cement used during treatment, Vertebral height recovery rate and cobb angle recovery.Results: The leakage rate of bone cement and the amount of bone cement in the group B was significantly lower than that in the group A(P<0.05). There was no significant difference in VAS score, vertebral height recovery rate and cobb angle recovery between the two groups(P>0.05). Conclusion: Compared with the vertebral vein dense area, the injection of bone cement in the sparse vertebral vein can significantly reduce the rate of cement leakage during PVP in patients with osteoporotic vertebral compression fracture. The venous venous sparse area can be used as PVP intraoperative bone. A relatively safe area for cement injection.