Li Yuwei, Yan Xiaoyun, Wang Haijiao, Cui Wei
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2015 Jul;29(7):845-8.
To discuss the effectiveness of high viscosity bone cement in unilateral puncture percutaneous vertebroplasty (PVP) for the treatment of osteoporotic fresh vertebral fracture and operation skills of the bone cement leakage prevention.
Between November 2005 and October 2013, 82 elderly patients with fresh thoracolumbar vertebral fracture were first treated with hyperextension postural reduction and then with high viscosity bone cement in unilateral pedicle puncture PVP. Of 82 cases, 25 were male and 57 were female with an average age of 72.3 years (range, 61-90 years). The causes included falling injury in 28 cases, sprain injury in 11 cases, car shock injury in 4 cases, fracture by cough or sneeze in 6 cases, and no obvious reason in 33 cases. The time from injury to operation was 3-15 days (mean, 7.6 days). Single segment was involved in 74 cases, and double segments in 8 cases. The operation time, fluoroscopy time, intraoperative blood loss, and hospitalization time were recorded, bone cement leakage was observed; pain visual analogue scale (VAS) was used to evaluate pain relief effect; X-ray films were taken for measurement of the Cobb angle and anterior vertebral body height compression ratio to evaluate the correction effect.
The average operation time was 16 minutes; the average fluoroscopy time was 48 seconds; the average hospitalization time was 3 days. All cases were followed up from 6 to 18 months (mean, 6.8 months). Leakage of bone cement occurred in 6 cases (7.3%), including 3 cases of paravertebral soft tissue leakage, 1 case of intervertebral disc leakage, and 2 cases of venous leakage. There was no nerve damage or paralysis. At last follow-up, VAS score was significantly decreased to 1.3 ± 0.9 from preoperative 8.8 ± 1.2 (t = 73.891, P = 0.000); Cobb angle was significantly reduced to (25.06 ± 6.18)° from preoperative (34.79 ± 7.18)° (t = 18.878, P = 0.000); and the anterior vertebral body height compression ratio was significantly increased to 67.8% ± 5.7% from preoperative 41.3% ± 9.8% (t = 36.880, P =0.000).
Application of high viscosity bone cement in unilateral puncture PVP can shorten operation time, reduce bone cement leakage rate, and achieve satisfactory effectiveness.
探讨高黏度骨水泥在单侧穿刺经皮椎体成形术（PVP）治疗骨质疏松性新鲜椎体骨折中的有效性及预防骨水泥渗漏的手术技巧。
2005年11月至2013年10月，82例老年新鲜胸腰椎椎体骨折患者，先行过伸体位复位，然后采用高黏度骨水泥单侧椎弓根穿刺PVP治疗。82例中，男25例，女57例，平均年龄72.3岁（范围61 - 90岁）。病因包括：摔伤28例，扭伤11例，车祸伤4例，咳嗽或打喷嚏致骨折6例，无明显诱因33例。受伤至手术时间为3 - 15天（平均7.6天）。单节段骨折74例，双节段骨折8例。记录手术时间、透视时间、术中出血量及住院时间，观察骨水泥渗漏情况；采用疼痛视觉模拟评分法（VAS）评估疼痛缓解效果；拍摄X线片测量Cobb角及椎体前缘高度压缩率以评估矫正效果。
平均手术时间为16分钟；平均透视时间为48秒；平均住院时间为3天。所有病例随访6 - 18个月（平均6.8个月）。骨水泥渗漏6例（7.3%），其中椎旁软组织渗漏3例，椎间盘渗漏1例，静脉渗漏2例。无神经损伤或瘫痪发生。末次随访时，VAS评分由术前8.8±1.2显著降至1.3±0.9（t = 73.891，P = 0.000）；Cobb角由术前（34.79±7.18）°显著降至（25.06±6.18）°（t = 18.878，P = 0.000）；椎体前缘高度压缩率由术前41.3%±9.8%显著升至67.8%±5.7%（t = 36.880，P = 0.000）。
高黏度骨水泥应用于单侧穿刺PVP可缩短手术时间，降低骨水泥渗漏率，疗效满意。
