To examine the clinical effects of a new bone cement composed of poly(methyl methacrylate)(PMMA)and mineralized collagen(MC)compared with pure PMMA bone cement in treating osteoporotic vertebral compression fractures(...To examine the clinical effects of a new bone cement composed of poly(methyl methacrylate)(PMMA)and mineralized collagen(MC)compared with pure PMMA bone cement in treating osteoporotic vertebral compression fractures(OVCFs)in patients aged over 80.In all,32 cases using pure PMMA bone cement and 31 cases using MC-modified PMMA(MC-PMMA)bone cement for OVCFs between June 2014 and March 2016 were screened as PMMA group and MC-PMMA group,respectively,with an average age of over 80.The operation duration,intraoperative blood loss,hospital stay,oswestry disability index(ODI),visual analogue scale(VAS),anterior vertebral height(AVH),intermediate vertebral height(IVH)and posterior vertebral height(PVH)of injured vertebrae,vertebral computed tomography value,re-fracture rate of adjacent vertebrae,correction rate of spinal kyphotic angle and wedge-shaped vertebra angle and surgical complications were compared between the two groups.In the early post-operative period,the VAS,ODI,AVH and IVH in MC-PMMA group were comparable to those in the traditional PMMA group.Moreover,the MC-PMMA group showed better effects compared with the PMMA group 12months after surgery.Thus,this new bone cement has superior clinic effects in the long term.展开更多
BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To r...BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell’s disease.METHODS Patients with Kümmell’s disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed.Patients meeting the inclusion and exclusion criteria were divided into two groups:Traditional single infusion and sequential infusion(SI).The visual analog scale(VAS)and Oswestry disability index(ODI)were evaluated and compared,and duration of operation,bone cement content and complications were recorded.RESULTS Forty-five patients were included in this study;there were 24 in the traditional single infusion group and 21 in the SI group.The VAS and ODI were significantly different for both groups when compared pre-and postoperatively,whereas the differences between 1 wk postoperatively and at the final follow-up were not statistically.When the VAS and ODI of the two groups were compared,there were no significant differences at any time point.The leakage rate of bone cement was significantly lower in the SI group(14.3%,3 of 21)than that in the traditional single infusion group(41.7%,10 of 24).CONCLUSION SI in unipedicular PVP is a safe and effective procedure for neurologically intact Kümmell’s disease,and this technique could decrease the incidence of bone cement leakage.展开更多
目的:探讨含重组人碱性成纤维细胞生长因子(recombinant human basic fibroblast growth factor,rhbFGF)和重组人骨形态发生蛋白-2(recombinant human bone morphogenetic protein-2,rhBMP-2)骨水泥在骨质疏松性腰椎压缩性骨折(osteopor...目的:探讨含重组人碱性成纤维细胞生长因子(recombinant human basic fibroblast growth factor,rhbFGF)和重组人骨形态发生蛋白-2(recombinant human bone morphogenetic protein-2,rhBMP-2)骨水泥在骨质疏松性腰椎压缩性骨折(osteoporotic vertebral compression fracture,OVCF)患者经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗的应用价值。方法:回顾性分析2018年1月至2021年1月收治的103例行PKP手术治疗的OVCF患者,男40例,女63例;年龄61~78(65.72±3.29)岁。受伤原因:滑倒33例,跌倒42例,提重物受伤28例。根据填充骨水泥不同分为3组:磷酸钙组34例,男14例,女20例,年龄(65.1±3.3)岁,填充磷酸钙骨水泥;rhBMP-2组34例,男12例,女22例,年龄(64.8±3.2)岁,填充含rhBMP-2的骨水泥;rhbFGF+rhBMP-2组35例,男14例,女21例,年龄(65.1±3.6)岁,填充含rhbFGF和rhBMP-2的骨水泥。比较3组Oswestry功能障碍指数(Oswestry dysfunction index,ODI)、骨密度、椎体前缘丢失高度、伤椎前缘压缩率、疼痛视觉模拟评分(visual simulation score,VAS)及再骨折发生率。结果:所有患者获得12个月随访。3组术后ODI、VAS呈下降(P<0.001),骨密度增高(P<0.001),椎体前缘丢失高度、伤椎前缘压缩率呈先下降后缓慢上升趋势(P<0.001),rhbFGF+rhBMP-2组术后第1、6、12个月ODI、VAS均低于rhBMP-2组和磷酸钙组(P<0.05),术后第6、12个月骨密度大于rhBMP-2组和磷酸钙组(P<0.05)。rhbFGF+rhBMP-2组术后第6、12个月椎体前缘丢失高度、伤椎前缘压缩率均低于rhBMP-2组和磷酸钙组(P<0.05)。3组再骨折发生率比较差异无统计学意义(P>0.05)。结论:含rhbFGF和rhBMP-2骨水泥可更有效地增加OVCF患者骨密度,获得术后满意的临床和放射学效果,显著改善临床症状。展开更多
基金This work was supported by Natural Science Foundation of Zhejiang Province(LY17H060001)Ningbo Natural Science Foundation(A610225).
文摘To examine the clinical effects of a new bone cement composed of poly(methyl methacrylate)(PMMA)and mineralized collagen(MC)compared with pure PMMA bone cement in treating osteoporotic vertebral compression fractures(OVCFs)in patients aged over 80.In all,32 cases using pure PMMA bone cement and 31 cases using MC-modified PMMA(MC-PMMA)bone cement for OVCFs between June 2014 and March 2016 were screened as PMMA group and MC-PMMA group,respectively,with an average age of over 80.The operation duration,intraoperative blood loss,hospital stay,oswestry disability index(ODI),visual analogue scale(VAS),anterior vertebral height(AVH),intermediate vertebral height(IVH)and posterior vertebral height(PVH)of injured vertebrae,vertebral computed tomography value,re-fracture rate of adjacent vertebrae,correction rate of spinal kyphotic angle and wedge-shaped vertebra angle and surgical complications were compared between the two groups.In the early post-operative period,the VAS,ODI,AVH and IVH in MC-PMMA group were comparable to those in the traditional PMMA group.Moreover,the MC-PMMA group showed better effects compared with the PMMA group 12months after surgery.Thus,this new bone cement has superior clinic effects in the long term.
文摘BACKGROUND Percutaneous vertebroplasty(PVP)is an effective method for the treatment of neurologically intact Kümmell’s disease,but bone cement leakage during surgery is a problem that deserves attention.AIM To reduce bone cement leakage and evaluate the effect of the sequential infusion of bone cement during PVP for the treatment of stage I or II Kümmell’s disease.METHODS Patients with Kümmell’s disease treated in our hospital from September 2015 to September 2018 were retrospectively analyzed.Patients meeting the inclusion and exclusion criteria were divided into two groups:Traditional single infusion and sequential infusion(SI).The visual analog scale(VAS)and Oswestry disability index(ODI)were evaluated and compared,and duration of operation,bone cement content and complications were recorded.RESULTS Forty-five patients were included in this study;there were 24 in the traditional single infusion group and 21 in the SI group.The VAS and ODI were significantly different for both groups when compared pre-and postoperatively,whereas the differences between 1 wk postoperatively and at the final follow-up were not statistically.When the VAS and ODI of the two groups were compared,there were no significant differences at any time point.The leakage rate of bone cement was significantly lower in the SI group(14.3%,3 of 21)than that in the traditional single infusion group(41.7%,10 of 24).CONCLUSION SI in unipedicular PVP is a safe and effective procedure for neurologically intact Kümmell’s disease,and this technique could decrease the incidence of bone cement leakage.
