He Shuangjun, Zhang Yijian, Lv Nanning, Wang Shujin, Wang Yaowei, Wu Shuhua, He Fan, Chen Angela, Qian Zhonglai, Chen Jianhong
Department of Orthopedics, The People's Hospital of Danyang, Danyang.
Department of Orthopedics, The First Affiliated Hospital of Soochow University, Suzhou, China.
Medicine (Baltimore). 2019 Dec;98(50):e18217. doi: 10.1097/MD.0000000000018217.
To evaluate the influence of various distributions of bone cement on the clinical efficacy of percutaneous kyphoplasty (PKP) in treating osteoporotic vertebrae compression fractures.A total of 201 OVCF patients (30 males and 171 females) who received PKP treatment in our hospital were enrolled in this study. According to the characteristic of cement distribution, patients were divided into 2 groups: group A ("H" shaped group), the filling pattern in vertebral body were 2 briquettes and connected with / without cement bridge; and group B ("O" shaped group), the filling pattern in vertebral body was a complete crumb and without any separation. Bone mineral density, volume of injected cement, radiographic parameters, and VAS scores were recorded and analyzed between the 2 groups.All patients finished at least a 1-year follow-up and both groups had significant improvement in radiographic parameters and clinical results. No significant differences in BMD, operation time, bleeding volume, or leakage of cement were observed between the 2 groups. Compared with group B, group A had a larger use of bone cement, lower proportion of unipedicular approach, and better VAS scores at 1 year after surgery.Both "H" and "O" shaped distribution pattern can improve radiographic data and clinical outcomes effectively. However, "H" shaped distribution can achieve better clinical recovery at short-term follow-up.
评估骨水泥不同分布对经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折临床疗效的影响。本研究纳入了我院201例接受PKP治疗的骨质疏松性椎体压缩骨折(OVCF)患者(男性30例,女性171例)。根据骨水泥分布特点,将患者分为2组:A组(“H”形组),椎体填充方式为2个骨块,有/无骨水泥桥连接;B组(“O”形组),椎体填充方式为完整碎骨,无任何分离。记录并分析两组患者的骨密度、注入骨水泥体积、影像学参数及视觉模拟评分(VAS)。所有患者均完成至少1年的随访,两组患者的影像学参数和临床结果均有显著改善。两组患者的骨密度、手术时间、出血量或骨水泥渗漏情况均无显著差异。与B组相比,A组骨水泥用量更大,单侧椎弓根入路比例更低,术后1年VAS评分更好。“H”形和“O”形分布模式均可有效改善影像学数据和临床结局。然而,“H”形分布在短期随访中可实现更好的临床恢复。