经皮椎体成形术术中应用高/低黏度骨水泥治疗椎体压缩性骨折的疗效比较

摘要

Objective To compare the effects of high-vs. low-viscosity bone cement on pain relief,spinal function improvement and postoperative complications in percutaneous vertebroplasty(PVP) for vertebral compression fracture. Methods The clinical data of 90 patients with vertebral compression fractures treated by PVP form January 2014 to March 2015 were retrospectively analyzed. In the early 45 cases,low viscosity bone cement(group L) was used during operation,and 45 cases were treated with high viscosity bone cement(group H) in the later stage. The cement injection,pain visual analogue scale(VAS) score,Oswestry disability index(ODI) and postoperative complications were recorded and compared between the 2 guoups. Results All patients successfully completed surgical treatment and were followed up for (1.63±0.13) years. There was no significant difference in preoperative VAS score and ODI between the 2 groups(P > 0.05). The VAS score and ODI of the 2 groups were significantly improved compared with those before operation,and the group H was superior to the group L,and the differences were statistically significant(P < 0.05). The incidence of bone cement leakage was lower in the group H(2.22%) than in the group L(15.56%), and the difference was statistically significant(P < 0.05). In the group L,5 patients(11.11%) had bone cement pulmonary embolism,and no pulmonary embolism occurred in the group H. Conclusion High viscosity bone cement used in PVP is superior to using low viscosity bone cement in relieving pain,improving spinal function and reducing postoperative complication rate.%目的 对比经皮椎体成形术(PVP)术中应用高/低黏度骨水泥对椎体压缩性骨折患者疼痛缓解、脊柱功能改善及术后并发症的影响. 方法 回顾性分析2014年1月—2015年3月采用PVP治疗的90例椎体压缩性骨折患者的临床资料.早期45例术中采用低黏度骨水泥(L组),后期45例采用高黏度骨水泥(H组).记录并比较2组患者水泥注入量、疼痛视觉模拟量表(VAS)评分、Oswestry功能障碍指数(ODI)与术后并发症的发生情况. 结果 所有患者均顺利完成手术治疗,术后随访(1.63±0.13)年.2组患者术前VAS评分和ODI差异无统计学意义(P > 0.05);2组患者术后VAS评分及ODI与术前相比均显著改善,且H组均优于L组,差异有统计学意义(P < 0.05).H组骨水泥渗漏发生率(2.22%)显著低于L组(15.56%),差异有统计学意义(P < 0.05).L组术后有5例(11.11%)患者发生骨水泥肺栓塞,H组未发生肺栓塞. 结论 PVP术中应用高黏度骨水泥在缓解患者疼痛,改善脊柱功能及降低术后并发症发生率方面优于使用低黏度骨水泥.