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聚甲基丙烯酸甲酯骨水泥有无矿化胶原修饰治疗骨质疏松性椎体压缩骨折的临床疗效比较

Clinical outcome comparison of polymethylmethacrylate bone cement with and without mineralized collagen modification for osteoporotic vertebral compression fractures.

作者信息

Wang Xi, Kou Jian-Ming, Yue Yang, Weng Xi-Sheng, Qiu Zhi-Ye, Zhang Xi-Feng

机构信息

Department of Orthopedics, Lianyungang Second People's Hospital, Lianyungang Jiangsu Department of Orthopedics, Peking Union Medical College Hospital School of Materials Science and Engineering, Tsinghua University Department of Orthopedics, Chinese PLA General Hospital, Beijing, China.

出版信息

Medicine (Baltimore). 2018 Sep;97(37):e12204. doi: 10.1097/MD.0000000000012204.

Abstract

A retrospective study of consecutive patients.The purpose of this study was to compare the clinical effect of biomimetic mineralized collagen (MC) modified polymethylmethacrylate (PMMA) bone cement and traditional PMMA bone cement for the treatment of osteoporotic vertebral compression fractures (OVCF).New fracture on adjacent level is the major postoperative complication of percutaneous vertebroplasty (PVP). The clinical incidence was 12.4% to 27.7%. The increased stiffness of the treated vertebral body caused by filling bone cement is considered as one of the main reasons.A total of 30 patients treated with traditional PMMA bone cement from June 2013 to March 2016 were selected as the traditional group, while 50 patients treated with MC modified PMMA bone cement from July 2014 to March 2016 were selected as the modified group. The 2 groups were compared by injection time of the bone cements, postoperative pain relief effects, vertebral height restoration, CT value changes of the treated vertebral bodies, and postoperative complications in the clinical observations.The surgeries were successfully completed in both groups. In the treatment of OVCF, the MC modified bone cement was able to achieve the same pain relief and vertebral height restoration effects compared to traditional bone cement during the follow-ups, although the injection time of the cement was prolonged in the operation. MC modified bone cement significantly reduced the incidence of postoperative adjacent vertebral fracture from 13.3% to 2%, and significantly increased bone density of the treated vertebral bodies.The MC modified PMMA bone cement showed good clinical outcomes and better mechanical properties than the traditional bone cements.

摘要

对连续患者的回顾性研究。本研究的目的是比较仿生矿化胶原蛋白(MC)改性聚甲基丙烯酸甲酯(PMMA)骨水泥与传统PMMA骨水泥治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果。相邻节段新发骨折是经皮椎体成形术(PVP)的主要术后并发症,临床发生率为12.4%至27.7%。填充骨水泥导致治疗椎体刚度增加被认为是主要原因之一。选取2013年6月至2016年3月采用传统PMMA骨水泥治疗的30例患者作为传统组,选取2014年7月至2016年3月采用MC改性PMMA骨水泥治疗的50例患者作为改良组。在临床观察中,比较两组骨水泥的注射时间、术后疼痛缓解效果、椎体高度恢复情况、治疗椎体的CT值变化以及术后并发症。两组手术均成功完成。在OVCF治疗中,MC改性骨水泥在随访期间与传统骨水泥相比能够达到相同的疼痛缓解和椎体高度恢复效果,尽管术中骨水泥注射时间延长。MC改性骨水泥显著降低了术后相邻椎体骨折的发生率,从13.3%降至2%,并显著提高了治疗椎体的骨密度。MC改性PMMA骨水泥显示出良好的临床效果,且力学性能优于传统骨水泥。

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