骨水泥2次推注与一次性推注完成在降低椎体成形术中骨水泥渗漏风险及术后相关并发症中的对比研究􀂷

A Comparative Study of Secondary Injection and one-time Injection of Bone Cement in Reducing the Risk of Bone Cement Leakage and Postoperative Complications During Vertebroplasty

目的:通过对骨折线累及椎体边缘的患者进行椎体成形术(PVP)治疗,观察骨水泥2次推注与一次性推注完成在降低骨水泥渗漏及术后相关并发症中的效果。方法:选取我院2020年4月-2021年3月因骨质疏松性椎体压缩性骨折(OVCFs)行PVP治疗的97例患者作为研究对象,所有患者CT均显示骨折线累及椎体前壁或上下终板,根据骨水泥推注方法不同进行分组研究,骨水泥一次性推注完成者纳入对照组,骨水泥分2次完成推注者纳入观察组。比较2组术后疼痛缓解情况、手术时间、骨水泥用量、骨水泥渗漏情况、术后并发症发生情况。结果:2组患者均顺利完成手术,同术前相比,术后疼痛均明显缓解(P<0.05)。2组患者术后VAS评分、手术时间、骨水泥用量组间比较无统计学差异(P>0.05);观察组患者骨水泥渗漏明显少于对照组(P<0.05);术后并发症2组比较无明显差异(P>0.05)。结论:对于存在椎体前壁或终板破裂的OVCFs患者行PVP治疗时,采用骨水泥2次推注的方式可明显减少术中骨水泥渗漏发生,提高手术安全性。

Objective:Through the treatment of vertebroplasty(PVP)for patients whose fracture line involves the edge of vertebral body,the effects of secondary injection and one-time injection of bone cement in reducing bone cement leakage and postoperative related complications were observed.Methods:97 patients with osteoporotic vertebral compression fractures(OVCFs)treated with PVP from April 2020 to March 2021 were selected as the research objects.CT of all patients showed that the fracture line involved the anterior wall or upper and lower endplates of the vertebral body.They were grouped according to different methods of bone cement injection.Those who completed one-time bone cement injection were included in the control group,Those who completed the injection of bone cement twice were included in the observation group.The postoperative pain relief,operation time,bone cement dosage,bone cement leakage and postoperative complications were compared between the two groups.Results:The patients in both groups successfully completed the operation,and the postoperative pain was significantly relieved compared with that before operation(P<0.05).There was no significant difference in postoperative VAS score,operation time and bone cement dosage between the two groups(P>0.05).The leakage of bone cement in the observation group was significantly less than that in the control group(P<0.05),and there was no significant difference in postoperative complications between the two groups(P>0.05).Conclusion:For OVCFs patients with vertebral anterior wall or endplate rupture,the secondary injection of bone cement can significantly reduce the occurrence of intraoperative bone cement leakage and improve the safety of operation.