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1 年随访:矿化胶原改性聚甲基丙烯酸甲酯骨水泥治疗骨质疏松性压缩性椎体骨折。

Mineralized Collagen Modified Polymethyl Methacrylate Bone Cement for Osteoporotic Compression Vertebral Fracture at 1-Year Follow-up.

机构信息

Department of Spinal Surgery, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, Zhejiang, China.

School of Materials Science and Engineering, Tsinghua University, Beijing, China.

出版信息

Spine (Phila Pa 1976). 2019 Jun 15;44(12):827-838. doi: 10.1097/BRS.0000000000002971.

Abstract

STUDY DESIGN

Retrospective comparative study.

OBJECTIVE

This study aimed to compare the clinical effects and imaging features of polymethyl methacrylate (PMMA) bone cement with and without mineralized collagen (MC) in percutaneous kyphoplasty (PKP) for osteoporotic vertebral compression fractures (OVCFs).

SUMMARY OF BACKGROUND DATA

PKP with PMMA is widely performed for OVCF. However, numerous complications have also been reported about the PMMA bone cement. Moreover, PMMA bone cement with and without MC have not been compared with respect to their postoperative efficacy and long-term follow-up.

METHODS

From July 2016 to July 2017, 105 OVCF patients were randomly divided into two groups based on their PKP treatment: MC-PMMA group and PMMA group. Clinical operation, cement leakage, Oswestry Disability Index, visual analog scale, height of the fractured vertebrae, Cobb angle, refracture of the adjacent vertebra, recompression, and computed tomography values of the injured vertebra were compared between the two groups postoperatively and after 1-year follow-up.

RESULTS

Clinical operation showed no differences between the two groups. Visual analog scale scores, Oswestry Disability Index scores, and Cobb angles showed statistically significant differences between the two groups after 1-year follow-up. The height of the vertebral body showed significant difference at 3 days postoperatively and preoperatively in each group and significant difference after 1 year between the two groups. The rate of refracture and leakage of the MC-PMMA group was lower than that of the PMMA group. The computed tomography value of the MC-PMMA group was obviously higher than that of the PMMA group after 1-year follow-up.

CONCLUSION

MC-modified PMMA did not change the beneficial properties of PMMA. This new bone cement has better biocompatibility, can form a stable structure in the vertebral body, and improve the prognosis of patients by reducing pain and reoperation.

LEVEL OF EVIDENCE

摘要

研究设计

回顾性对比研究。

目的

本研究旨在比较经皮椎体后凸成形术(PKP)中使用含与不含矿化胶原(MC)的聚甲基丙烯酸甲酯(PMMA)骨水泥治疗骨质疏松性椎体压缩性骨折(OVCF)的临床效果和影像学特征。

背景资料概要

PKP 联合 PMMA 广泛应用于 OVCF 的治疗。然而,PMMA 骨水泥也报道了许多并发症。此外,尚未比较过含 MC 的 PMMA 骨水泥和不含 MC 的 PMMA 骨水泥在术后疗效和长期随访方面的差异。

方法

2016 年 7 月至 2017 年 7 月,根据 PKP 治疗将 105 例 OVCF 患者随机分为两组:MC-PMMA 组和 PMMA 组。比较两组患者术后和 1 年随访时的临床手术情况、骨水泥渗漏、Oswestry 功能障碍指数(ODI)、视觉模拟评分(VAS)、骨折椎体高度、Cobb 角、相邻椎体再骨折、再压缩和伤椎 CT 值。

结果

两组患者的临床手术情况无差异。两组患者术后 1 年 VAS 评分、ODI 评分和 Cobb 角比较,差异均有统计学意义。两组患者术后 3 天及术前椎体高度比较,差异均有统计学意义;两组患者术后 1 年椎体高度比较,差异亦有统计学意义。MC-PMMA 组再骨折和骨水泥渗漏发生率低于 PMMA 组。术后 1 年随访时,MC-PMMA 组 CT 值明显高于 PMMA 组。

结论

MC 改性 PMMA 并未改变 PMMA 的有益特性。这种新型骨水泥具有更好的生物相容性,可在椎体内形成稳定结构,通过减轻疼痛和减少再次手术来改善患者的预后。

证据等级

3 级

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