不同骨水泥灌注量经单侧PVP治疗骨质疏松性椎体压缩骨折的临床疗效
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摘要
目的观察不同骨水泥灌注量经单侧经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCF)的临床疗效及并发症影响。方法选取86例行单侧PVP治疗OVCF患者,按随机数字表法分为两组各43例,A组使用小剂量骨水泥灌注,B组使用常规剂量骨水泥灌注,比较两组治疗前与结束随访时椎体高度变化、责任椎Cobb角、视觉模拟疼痛评分(VAS)、Oswestry功能障碍指数(ODI),并观察两组手术指标、骨水泥渗漏事件与并发症情况。结果两组手术时间及术中出血量比较差异无统计学意义(P> 0. 05),A组骨水泥灌注量少于B组(P <0. 05);两组治疗前与结束随访时椎体前壁高度、椎体中间高度、责任椎Cobb角、VAS评分、ODI比较差异无统计学意义(P> 0. 05),两组结束随访时椎体前壁高度、椎体中间高度均较治疗前明显增加,责任椎Cobb角、VAS评分及ODI均较治疗前明显减小(P <0. 05); A组骨水泥渗漏事件发生率、并发症总发生率低于B组(P <0. 05)。结论在PVP治疗OVCF中使用小剂量或者常规剂量骨水泥灌注均能获得良好疗效,其中小剂量骨水泥灌注具有减少骨水泥渗漏事件、降低术后并发症发生率优势,安全性更高。
Objective To observe the effect of different bone cement perfusion in unilateral percutaneous vertebroplasty( PVP) on clinical curative effect and complications in the treatment of osteoporotic vertebral compression fractures( OVCF).Methods Eighty-six patients undergoing the unilateral PVP for OVCF were randomly divided into A and B groups,43 in each group.The group A was treated with low-dose bone cement perfusion,and the group B was treated with conventional dose perfusion.Changes of vertebral height,responsible vertebral Cobb angle,pain visual analogue scale( VAS) scores and Oswestry disability index( ODI) were compared between the two groups before treatment and at the end of follow-up.The surgical indexes,bone cement leakage and complications in the two groups were observed.Results There was no significant difference in the surgical time or intraoperative blood loss between the two groups( P > 0. 05).The bone cement perfusion in the group A was significantly less than that in the group B( P < 0. 05).There was no significant difference in the vertebral anterior wall height,middle vertebral height,responsible vertebral Cobb angle,VAS score or ODI between the two groups before treatment and during the period of follow-up( P > 0. 05).However,at the end of follow-up,the vertebral anterior wall height and middle vertebral height in both groups were significantly increased while responsible vertebral Cobb angle,VAS score and ODI were significantly decreased when compared with those before treatment( P < 0. 05).The incidence rate of bone cement leakage and total incidence of complications in the group A were significantly lower than those in the group B( P < 0. 05).Conclusion Both low-dose and conventional-dose bone cement in PVP for OVCF can achieve good curative effect. Low-dose bone cement perfusion has advantages of reducing bone cement leakage and the incidence of postoperative complications.Its safety is higher.
Objective To observe the effect of different bone cement perfusion in unilateral percutaneous vertebroplasty( PVP) on clinical curative effect and complications in the treatment of osteoporotic vertebral compression fractures( OVCF).Methods Eighty-six patients undergoing the unilateral PVP for OVCF were randomly divided into A and B groups,43 in each group.The group A was treated with low-dose bone cement perfusion,and the group B was treated with conventional dose perfusion.Changes of vertebral height,responsible vertebral Cobb angle,pain visual analogue scale( VAS) scores and Oswestry disability index( ODI) were compared between the two groups before treatment and at the end of follow-up.The surgical indexes,bone cement leakage and complications in the two groups were observed.Results There was no significant difference in the surgical time or intraoperative blood loss between the two groups( P > 0. 05).The bone cement perfusion in the group A was significantly less than that in the group B( P < 0. 05).There was no significant difference in the vertebral anterior wall height,middle vertebral height,responsible vertebral Cobb angle,VAS score or ODI between the two groups before treatment and during the period of follow-up( P > 0. 05).However,at the end of follow-up,the vertebral anterior wall height and middle vertebral height in both groups were significantly increased while responsible vertebral Cobb angle,VAS score and ODI were significantly decreased when compared with those before treatment( P < 0. 05).The incidence rate of bone cement leakage and total incidence of complications in the group A were significantly lower than those in the group B( P < 0. 05).Conclusion Both low-dose and conventional-dose bone cement in PVP for OVCF can achieve good curative effect. Low-dose bone cement perfusion has advantages of reducing bone cement leakage and the incidence of postoperative complications.Its safety is higher.
引文
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[4]吴金伟,邹伟民,吕海等.骨水泥在骨质疏松性椎体骨折线内弥散情况对椎体成形术疗效的影响[J].医学临床研究,2017,34(5):846-849.
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[7]郭振鹏,尚晖,李小琴,等.高粘度与低粘度骨水泥PVP治疗骨质疏松性椎体压缩骨折疗效及安全性分析[J].生物骨科材料与临床研究,2016,13(2):17-19.
[8]邓亦奇,赵峰,李国华,等.中粘度与高粘度骨水泥治疗骨质疏松性椎体压缩骨折的疗效对比[J].颈腰痛杂志,2016,37(1):17-22.
[9]张辉,高中玉,许财元,等.骨质疏松性椎体压缩骨折椎体成形:漏诊、重度椎体压缩、骨水泥渗漏及再发骨折225例分析[J].中国组织工程研究,2016,20(35):5256-5262.
[10]苟鹏国,常峰.小剂量骨水泥经皮椎体后凸成形术联合体位复位治疗骨质疏松性椎体压缩骨折[J].中国药物与临床,2016,16(3):395-397.
[11]蔡斌,王文军,宋西正,等.遥控骨水泥自动推进器辅助下经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折[J].中国矫形外科杂志,2016,24(10):865-869.
[12]何保玉,刘宝戈,李学民,等.骨水泥弥散容积率在骨质疏松性椎体压缩骨折PKP术后疗效评价中的应用[J].中国骨与关节杂志,2016,5(1):68-73.
[2]李志荣,刘立岷.椎体后凸成形术配合唑来膦酸治疗骨质疏松性胸腰椎压缩性骨折疗效分析[J].湖南师范大学学报(医学版),2017,14(3):78-81.
[3]韩树铭.经皮单侧椎体成形术治疗骨质疏松性椎体压缩骨折的疗效观察[J].中国基层医药,2017,24(22):3421-3425.
[4]吴金伟,邹伟民,吕海等.骨水泥在骨质疏松性椎体骨折线内弥散情况对椎体成形术疗效的影响[J].医学临床研究,2017,34(5):846-849.
[5]闫伟,杨莉.骨质疏松性椎体压缩骨折的影像学诊断[J].中国CT和MRI杂志,2017,15(11):135-137.
[6]张贺庆,刘洪涛,吕宏琳,等.两种骨水泥治疗老年骨质疏松性椎体压缩骨折的比较[J].实用骨科杂志,2016,22(4):343-346.
[7]郭振鹏,尚晖,李小琴,等.高粘度与低粘度骨水泥PVP治疗骨质疏松性椎体压缩骨折疗效及安全性分析[J].生物骨科材料与临床研究,2016,13(2):17-19.
[8]邓亦奇,赵峰,李国华,等.中粘度与高粘度骨水泥治疗骨质疏松性椎体压缩骨折的疗效对比[J].颈腰痛杂志,2016,37(1):17-22.
[9]张辉,高中玉,许财元,等.骨质疏松性椎体压缩骨折椎体成形:漏诊、重度椎体压缩、骨水泥渗漏及再发骨折225例分析[J].中国组织工程研究,2016,20(35):5256-5262.
[10]苟鹏国,常峰.小剂量骨水泥经皮椎体后凸成形术联合体位复位治疗骨质疏松性椎体压缩骨折[J].中国药物与临床,2016,16(3):395-397.
[11]蔡斌,王文军,宋西正,等.遥控骨水泥自动推进器辅助下经皮椎体成形术治疗骨质疏松性胸腰椎压缩性骨折[J].中国矫形外科杂志,2016,24(10):865-869.
[12]何保玉,刘宝戈,李学民,等.骨水泥弥散容积率在骨质疏松性椎体压缩骨折PKP术后疗效评价中的应用[J].中国骨与关节杂志,2016,5(1):68-73.