经皮后凸成形术骨水泥弥散的相关因素

Factors related to bone cement distribution in percutaneous kyphoplasty

[目的]探讨经皮后凸成形术(percutaneous kyphoplasty,PKP)治疗胸腰椎骨质疏松压缩骨折(osteoporotic vertebral compression fracture,0VCF)影响骨水泥弥散程度的相关因素。[方法]2017年3月一2019年3月在本院因0VCF行PKP手术的103例患者纳人本研究,影像测量术后骨水泥弥散系数。按不同因素分组,比较骨水泥弥散系数的差异。[结果]按手术时机,骨水泥分布系数依次为,新鲜组>亚急性组>陈旧组,差异有统计学意义(P<0.05)。按骨水泥注入量,骨水泥分布系数为,低注入量组>高注入量,差异有统计学意义(P<0.05)。按骨折程度,骨水泥分布系数为,Ⅰ度组>Ⅱ度组>Ⅲ度组,差异有统计学意义(P<0.05)。按骨水泥状态,高粘与低粘骨水泥间骨水泥分布系数的差异无统计学意义(P>0.05),但高粘度组大部分呈实心团块状弥散,而低粘度骨水泥多呈蜂窝状。渗漏率高粘度骨水泥为2/53(3.77%),而低粘度骨水泥为3/50(6.00%)。[结论]PKP随着骨折至手术时间、骨水泥注射量、椎体压缩程度的增加,骨水泥的扩散系数逐渐减小。

[Objective]To explore the factors related to bone cement distribution in percutaneous kyphoplasty(PKP)for thoracolumbar osteoporotic vertebral compression fractures(OVCF).[Methods]From March 2017 to March 2019,103 patients who underwent PKP for OVCF in our hospital were included in this study.The postoperative bone cement distribution coefficient(BCDC)was calculated by imaging measurement.The patients were divided into groups based on different factors,and then the BCDCs were compared among different groups.[Results]In term of surgical timing,the BCDC was ranked up-down in order of acute group>subacute group>delayed group,which was statistically significant(P<0.05).In term of volume of bone cement injected,the BCDC was significantly greater in the low-volume group than that in the high-volume group(P<0.05).In term of extent of fracture compression,the BCDC was arranged up-down as Grade Ⅰ>Grade Ⅱ>Grade Ⅲ,which proved statistically significant(P<0.05).In term of bone cement state,there was no a statistically significant difference in BCDC between the high-viscosity group and low viscosity group(P>0.05).However,most of the high-viscosity group was seen solid mass distribution,while the low-viscosity group was found mostly honeycomb-like distribution.The bone cement leakage was noted 2/53(3.77%)in the high-viscosity group,whereas 3/50(6.00%)in the low-viscosity group.[Conclusion]With the increase of the interval from fracture to operation,volume of bone cement injected and extent of vertebral compression,the BCDC decreases gradually.