Li Jigang, Li Tao, Ma Qiuhong, Li Jianmin
Orthopedic Department, Shandong University Qilu Hospital, Wenhua Road 107, 250000, Jinan City, Shandong Province, China; Orthopedic Department, Zibo Central Hospital, Gongqingtuan Road 54, 255000, Zibo City, Shandong Province, China.
Orthopedic Department, Zibo Central Hospital, Gongqingtuan Road 54, 255000, Zibo City, Shandong Province, China.
J Orthop Sci. 2017 Sep;22(5):811-815. doi: 10.1016/j.jos.2017.05.001. Epub 2017 Jun 9.
Percutaneous vertebroplasty has been widely applied in the treatment of osteoporotic vertebral compression fractures over the past two decades. However as one of the major complications, the rate of cement leakage seems not to be decreased significantly. In this study, the rate of cement leakage was compared between two groups using two different cement injection cannulas. The purpose was to determine the efficacy of side-opening cannula on preventing cement leakage in vertebroplasty for the treatment of osteoporotic vertebral compression fractures.
A retrospective study was conducted from January 2013 to December 2015. Totally 225 patients who received bilateral vertebroplasty due to osteoporotic vertebral compression fractures were included in the study. The patients were divided into test group who received vertebroplasty with side-opening cannulas and control group who received vertebroplasty with front-opening cannulas. The patients' medical records were reviewed to determine the bone marrow density, preoperative vertebral compression ratio, preoperative and postoperative VAS, operation time, volume of injected bone cement, rate of cement leakage. Post-operative X-rays and CT scans were utilized to assess the degree of Cement leakage. Comparisons between groups and clinical results on VAS in each group were analyzed with appropriate test.
All the patients were performed successfully without symptomatic complications. The back pain was significantly relieved after operation in both groups (P < 0.05). At 6 days and 6 months follow-up, there was no significant difference in the mean VAS score between the two groups (P > 0.05). The rate of cement leakage in the test group was significantly lower than that in the control group (P < 0.05).
Percutaneous vertebroplasty with side-opening cannula is a safe and effective minimally invasive method in the treatment of osteoporotic vertebral compression fractures, the rate of cement leakage can be significantly reduced by redirecting the cement flow.
在过去二十年中，经皮椎体成形术已广泛应用于骨质疏松性椎体压缩骨折的治疗。然而，作为主要并发症之一，骨水泥渗漏率似乎并未显著降低。在本研究中，比较了使用两种不同骨水泥注射套管的两组之间的骨水泥渗漏率。目的是确定侧开口套管在经皮椎体成形术治疗骨质疏松性椎体压缩骨折中预防骨水泥渗漏的疗效。
进行一项回顾性研究，时间跨度为2013年1月至2015年12月。共有225例因骨质疏松性椎体压缩骨折接受双侧椎体成形术的患者纳入本研究。患者被分为接受侧开口套管椎体成形术的试验组和接受前开口套管椎体成形术的对照组。查阅患者病历以确定骨髓密度、术前椎体压缩率、术前和术后视觉模拟评分（VAS）、手术时间、注入骨水泥的体积、骨水泥渗漏率。利用术后X线和CT扫描评估骨水泥渗漏程度。采用适当的检验分析组间比较及每组VAS的临床结果。
所有患者手术均成功，无明显并发症。两组术后背痛均明显缓解（P < 0.05）。在术后6天和6个月随访时，两组间平均VAS评分无显著差异（P > 0.05）。试验组骨水泥渗漏率显著低于对照组（P < 0.05）。
侧开口套管经皮椎体成形术是治疗骨质疏松性椎体压缩骨折安全有效的微创方法，通过改变骨水泥流动方向可显著降低骨水泥渗漏率。
