高黏度骨水泥PVP与低黏度骨水泥PKP治疗骨质疏松性椎体压缩骨折的比较
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摘要
目的比较复位后高黏度骨水泥PVP与低黏度骨水泥PKP治疗骨质疏松性椎体压缩骨折的疗效和安全性。方法回顾性分析郑州市第一人民医院接受复位后高黏度骨水泥PVP与低黏度骨水泥PKP两种手术方法治疗骨质疏松性椎体压缩骨折的患者,通过视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体前缘高度及有无渗漏来比较两种方法。结果在VAS、ODI、椎体前缘高度及渗漏率方面,两组均差异无统计学意义(P>0.05);1个月时,两组的椎体前缘高度差异有统计学意义(P<0.05)。结论复位后高黏度骨水泥PVP与低黏度骨水泥PKP在治疗骨质疏松性椎体压缩骨折具有相似的治疗效果及安全性,但前者费用低,能显著减轻患者经济负担,可作为治疗骨质疏松性椎体压缩骨折的新选择。
Objective To compare the efficacy and safety of high-viscosity bone cement PVP after reduction and low-viscosity cement PKP in the treatment of osteoporotic vertebral compression fractures( OVCF). Methods Patients with OVCF wrer divided into two groups: high-viscosity bone cement PVP after reduction and low-viscosity cement PKP groups,the outcomes were assessed by the visual analogue scale( VAS),Oswestry disability index( ODI),anterior vertebral height and leakage rate. Results There were no statistical differences between the two methods in VAS,ODI,anterior vertebral height and leakage rate( P > 0. 05); There were significant differences in the anterior vertebral height between the two groups at 1 month( P < 0. 05). Conclusion There were similar therapeutic effect and safety in the treatment of OVCF by high-viscosity bone cement PVP after reduction and low-viscosity cement PKP,the former has low cost and can significantly reduce the economic burden of patients,and can be used as a new option for OVCF.
Objective To compare the efficacy and safety of high-viscosity bone cement PVP after reduction and low-viscosity cement PKP in the treatment of osteoporotic vertebral compression fractures( OVCF). Methods Patients with OVCF wrer divided into two groups: high-viscosity bone cement PVP after reduction and low-viscosity cement PKP groups,the outcomes were assessed by the visual analogue scale( VAS),Oswestry disability index( ODI),anterior vertebral height and leakage rate. Results There were no statistical differences between the two methods in VAS,ODI,anterior vertebral height and leakage rate( P > 0. 05); There were significant differences in the anterior vertebral height between the two groups at 1 month( P < 0. 05). Conclusion There were similar therapeutic effect and safety in the treatment of OVCF by high-viscosity bone cement PVP after reduction and low-viscosity cement PKP,the former has low cost and can significantly reduce the economic burden of patients,and can be used as a new option for OVCF.
引文
[1]杨丰建,林伟龙,朱炯,等.经皮椎体成形术和经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折[J].中国脊柱脊髓杂志,2011,21(1):50-54.
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[5]王诗军,邑晓东,李淳德,等.经皮椎体成形中椎旁血管渗漏与骨水泥性肺栓塞[J].中国组织工程研究,2013,17(47):8275-8281.
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[8]Nieuwenhuijse MJ,Muijs SP,van Erkel AR,et al.A clinical comparative study on low versus medium viscosity polymethylmetacrylatebone cement in percutaneous vertebroplasty:viscosity associated withcement leakage[J].Spine,2010,35(20):1037-1044.
[9]Papanastassiou I D,Phillips FM,Van Meirhaeghe J,et al.Comparingeffects of kyphoplasty,vertebroplasty,and non-surgical management in a systematic review of randomized and non-randomized controlled studies[J].Eur Spine J,2012,9:1826-1843.
[10]Friedrich HC,Friedrich HJ,Kneisel P,et al.Balloonkyphoplastyimproves back pain but does not result in a permanent realignment ofthe thoracolumbar spine[J].Cent Eur Neurosurg,2011,72(4):176-180.
[11]刘伟,郑君涛,马原.不同容量骨水泥用于经皮椎体成型穿刺椎体成形术的疗效评价[J].中国矫形外科杂志,2011,19(16):1394-1395.
[2]杜云峰,王红星,杨小超,等.手法复位配合PVP治疗老年骨质疏松性椎体压缩骨折患者54例分析[J].中国矫形外科杂志,2017,25(12):1149-1152.
[3]李玉伟,严晓云,王海蛟,等.应用高黏度骨水泥单侧穿刺经皮椎体成形术治疗新鲜椎体骨折[J].中国修复重建外科杂志,2015,29(7):845-848.
[4]徐超,伊力哈木·托合提,李国华,等.高粘度与低粘度骨水泥PVP治疗骨质疏松椎体压缩骨折的疗效和并发症[J].中国脊柱脊髓杂志,2014,24(10):900-905.
[5]王诗军,邑晓东,李淳德,等.经皮椎体成形中椎旁血管渗漏与骨水泥性肺栓塞[J].中国组织工程研究,2013,17(47):8275-8281.
[6]Georgy BA.Clinical experience with hig-viscosity cements for percutaneous vertebral body augmentation:occurrence,degree,andlocation ofcement leakage compared with kyphoplasty[J].Ajnr American Journalof Neuroradiology,2010,31(3):504-508.
[7]Anselmetti GC,Zoarski G,Manca A,et al.Percutaneousvertebroplasty and bone cementleakage:clinical experience with a new high-viscosity bone cement and deliverysystem for vertebral augmentation in benign and malignant compression fractures[J].Cardiovascular&Interventional Radiology,2008,31(5):937-947.
[8]Nieuwenhuijse MJ,Muijs SP,van Erkel AR,et al.A clinical comparative study on low versus medium viscosity polymethylmetacrylatebone cement in percutaneous vertebroplasty:viscosity associated withcement leakage[J].Spine,2010,35(20):1037-1044.
[9]Papanastassiou I D,Phillips FM,Van Meirhaeghe J,et al.Comparingeffects of kyphoplasty,vertebroplasty,and non-surgical management in a systematic review of randomized and non-randomized controlled studies[J].Eur Spine J,2012,9:1826-1843.
[10]Friedrich HC,Friedrich HJ,Kneisel P,et al.Balloonkyphoplastyimproves back pain but does not result in a permanent realignment ofthe thoracolumbar spine[J].Cent Eur Neurosurg,2011,72(4):176-180.
[11]刘伟,郑君涛,马原.不同容量骨水泥用于经皮椎体成型穿刺椎体成形术的疗效评价[J].中国矫形外科杂志,2011,19(16):1394-1395.