明胶海绵碎屑预填注在经皮椎体成形术中预防骨水泥渗漏的临床观察

Clinical observation on prevention of bone cement leakage inpercutaneous vertebroplasty with gelatin sponge

目的探讨明胶海绵碎屑预填注在经皮椎体成形术(percutaneous vertebro plasty,PVP)中预防骨水泥渗漏的作用。方法选取2017年12月~2020年10月本院收治的骨质疏松性椎体压缩骨折患者84例,按照随机数字法将其分为观察组(n=42)和对照组(n=42)。两组患者入院后均进行常规PVP手术治疗,观察组在PVP术中应用明胶海绵碎屑预填注椎体破损处。术后对两组患者的骨水泥渗漏发生率、VAS评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、伤椎前缘高度及伤椎后凸角变化情况进行比较。结果对照组患者的骨水泥渗漏发生率(16.67%)显著高于观察组(2.38%),差异有统计学意义(P<0.05)。两组患者术后3 d、术后3个月的VAS评分和ODI指数均获得显著改善(P<0.05),伤椎前缘高度和后凸角均得到一定程度矫正,但两组间差异无统计学意义(P>0.05)。结论在PVP术中应用明胶海绵碎屑对骨水泥渗漏具有一定的预防作用,且对PVP手术疗效无不利影响,有临床应用价值。

Objective To investigate the role of gelatin sponge prefilling in prevention of bone cement leakage during percutaneous vertebroplasty(PVP).Methods From December 2017 to October 2020,84 patients with osteoporotic vertebral compression fractures in our hospital were selected and randomly divided into observation group(n=42)and control group(n=42).Both two groups were treated with routine PVP operation after admission,and the observation group was injected with gelatin sponge debris in the damaged vertebral body during PVP operation.The incidence of bone cement leakage,VAS score,Oswestry disability index(ODI),anterior height of injured vertebra and kyphosis angle of injured vertebra were compared between the two groups.Results The incidence rate of bone cement leakage in the control group(16.67%)was significantly higher than that in the observation group(2.38%),the difference was statistically significant(P<0.05).The VAS score and ODI index of the two groups were significantly improved at 3 days and 3 months after operation(P<0.05),and the anterior height and kyphosis angle of the injured vertebra were corrected to a certain extent,but there was no significant difference between the two groups(P>0.05).Conclusion The application of gelatin sponge debris in PVP has certain preventive effect on bone cement leakage,and has no adverse effect on the curative effect of PVP,so it has clinical application value.