PKP术中不同剂量骨水泥注入对老年绝经后OVCF患者的疗效

The efficacy of different dosage of bone cement injection in PKP surgery in elderly OVCF patients

目的分析经皮穿刺椎体后凸成形术(PKP)术中注入不同剂量骨水泥对绝经后骨质疏松性腰椎体压缩性骨折(OVCF)患者脊柱功能的影响。方法选取于我院就诊的绝经后OVCF老年患者135例作,按照随机数字表法分为对照组和观察组,对照组67例,观察组68例。对照组PKP术中注入常规剂量骨水泥,观察组PKP术中注入小剂量骨水泥。随访1年,采用视觉模拟评分(VAS)以及Oswsetry功能障碍指数(ODI)评价两组患者手术前和术后1周下肢疼痛程度及功能障碍、脊柱功能及术后骨水泥渗漏的发生率。结果术后1周末,两组VAS、ODI评分无差异(P>0.05);术后1周和术后1年观察组椎体前缘高度、椎体中部高度低于对照组(P<0.05);观察组患者骨水泥渗漏发生率低于对照组(P<0.05)。结论PKP术中注入常规剂量的骨水泥与小剂量骨水泥均可有效降低绝经后OVCF老年患者疼痛,改善患者下肢功能障碍及脊柱功能,但小剂量骨水泥可降低骨水泥渗漏的发生率。

Objective To analyze the effect of different dosage of bone cement injection in percutaneous verte⁃bral kyphoplasty(PKP)on the spine function of elderly patients with postmenopausal osteoporotic lumbar vertebral com⁃pression fractures(OVCF).Methods 135 elderly patients with OVCF who were treated in our hospital were selected and randomly divided into the control group(67 cases)and the observation group(68 cases).The control group was in⁃jected with regular dosage of bone cement during PKP operation and the observation group was injected with low dos⁃age of bone cement during PKP operation.After 1 year of followed-up,the visual analogue scale of leg pain(VAS)and Oswsetry dysfunction index(ODI)were used to evaluate the pain and dysfunction of lower extremities.The spine func⁃tion and postoperative bone cement leakage rate of the two groups before and 1 week after surgery were compared.Re⁃sults There were no difference in the VAS and ODI scores between the two groups at the end of one week(P>0.05);the anterior edge height of the vertebral body and the middle height of the vertebral body of the observation group were lower than those in the control group one week after the operation and one year after operation(P<0.05).The incidence of bone cement leakage in the observation group was lower than that in the control group(P<0.05).Conclusion Inject⁃ing bone cement during PKP surgery can effectively reduce the pain of elderly patients with OVCF,improve lower limb dysfunction and spinal function,but low dosage of bone cement injection can reduce bone cement leakage.