Yang Jun
Department of Orthopaedics, Hospital Affiliated to Xinyang Vocational and Technical College, Xinyang 464000, Henan, China;
Zhongguo Gu Shang. 2019 Dec 25;32(12):1128-1133. doi: 10.3969/j.issn.1003-0034.2019.12.012.
To investigate the effect of bone cement dispersion and distribution on the clinical effect and the degree of pain reduction of percutaneous vertebroplasty(PVP) in the treatment of osteoporosis spinal fracture.
A retrospective analysis was made of 130 cases of osteoporotic spinal fractures admitted from August 2016 to April 2018, of which 114 cases were followed up completely. The VAS score, Oswestry disability index(ODI), kyphosis angle(Cobb angle), anterior column height and complications were analyzed.
Finally, 114 cases were included. The grade of bone cement dispersion was 42 cases (36.8%) in grade 1, including 14 males and 28 females, with an average age of (73.43 ±7.91) years. There were 36 cases of grade 2(31.6%), including 10 males and 26 females with an average age of (71.22 ±8.06) years, and 36 cases with grade 3 (31.6%), including 9 males and 27 females, with an average age of (74.81 ±6.91) years. There were no significant differences in preoperative general data among the three groups (>0.05). The VAS, ODI score of grade 1, grade 2 and grade 3 of bone cement dispersion and distribution were significantly lower than those of preoperative follow-up(<0.05) in the follow-up period of 1, 1, 3 and 6 months after operation(<0.05). There were no significant differences between the three groups in using single factor ANOVA at the same time point of postoperative follow-up(>0.05). In terms of bone cement leakage, 15 cases(41.7%) were in grade 2 of diffusion distribution, 23 cases(63.9%) in grade 3 more than 8 cases(19%) in grade 1 of diffusion distribution, exhibiting a significant difference among the three groups (<0.05). The diffusive distribution in grade 2(7, 19.4%) and grade 3(8, 22.2%) less than that in grade 1(18, 42.9%)(<0.05). Bone cement dispersion and distribution with grade 2 and 3 level could effectively improve the kyphosis deformity and reduce the loss of anterior column height in the injured vertebrae compared with that with grade 1, showing a statistical difference among the three groups(<0.05).
Bone cement dispersion and distribution with any grades in PVP are effective in relieving pain, and bone cement dispersion and distribution with grade 2 could not only relieve the pain of patients, but also correct the kyphosis angle of the injured vertebrae. The height of the anterior column of the injured vertebrae and the risk of cement leakage and non-operative vertebral body fracture is relatively low.
探讨骨水泥弥散分布对经皮椎体成形术（PVP）治疗骨质疏松性脊柱骨折临床疗效及疼痛缓解程度的影响。
回顾性分析2016年8月至2018年4月收治的130例骨质疏松性脊柱骨折患者资料，其中114例获得完整随访。分析视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、后凸角（Cobb角）、伤椎前缘高度及并发症情况。
最终纳入114例患者。骨水泥弥散1级42例（36.8%），其中男14例，女28例，平均年龄（73.43±7.91）岁；2级36例（31.6%），其中男10例，女26例，平均年龄（71.22±8.06）岁；3级36例（31.6%），其中男9例，女27例，平均年龄（74.81±6.91）岁。三组术前一般资料比较差异无统计学意义（>0.05）。术后1、1、3、6个月随访时，骨水泥弥散分布1、2、3级的VAS、ODI评分均显著低于术前随访（<0.05）。术后随访同一时间点三组采用单因素方差分析比较差异无统计学意义（>0.05）。骨水泥渗漏方面，弥散分布2级15例（41.7%）、3级23例（63.9%）多于1级8例（19%），三组比较差异有统计学意义（<0.05）。2级（7例，19.4%）和3级（8例，22.2%）的弥散分布少于1级（18例，42.9%）（<0.05）。与1级相比，2、3级骨水泥弥散分布能有效改善伤椎后凸畸形，减少伤椎前缘高度丢失，三组比较差异有统计学意义（<0.05）。
PVP中任何级别的骨水泥弥散分布均能有效缓解疼痛，2级骨水泥弥散分布不仅能缓解患者疼痛，还能矫正伤椎后凸角，伤椎前缘高度及骨水泥渗漏和非手术椎体骨折风险相对较低。
