Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
World Neurosurg. 2021 Jun;150:e218-e227. doi: 10.1016/j.wneu.2021.02.133. Epub 2021 Mar 13.
We sought to evaluate the efficacy and complications of percutaneous vertebroplasty with different viscosities and volumes of bone cement in treating osteoporotic vertebral compression fractures (OVCFs).
We conducted a retrospective cohort study of 307 patients treated for a single thoracolumbar level (T12-L2) OVCF in our hospital between January 2014 and December 2019. The patients were divided into 6 groups according to different viscosities (I: low-viscosity bone cement, II: high-viscosity bone cement) and injection volumes (A, 2-4 mL; B, 4-6 mL; C, 6-8 mL) of bone cement. Clinical and radiologic characteristics including visual analog scale, local kyphotic angle, anterior vertebral height ratio, cement leakage, and vertebral body recollapse rate were collected preoperatively, 2 days postoperation, and at the last follow-up to assess the efficacy and complications of each group.
Regarding efficacy, there was no significant difference between the 2 kinds of bone cement. Injecting >4 mL of cement can provide patients with good improvements of clinical indicators and a low vertebral body recollapse rate. Injecting 6-8 mL of bone cement slightly improved the radiologic indicators. However, the leakage rate of low-viscosity bone cement increased significantly when the volume exceeded 6 mL. The leakage rate of high-viscosity bone cement did not increase significantly at the volume of 6-8 mL.
In summary, when treating single thoracolumbar level OVCFs, the recommended volume of low-viscosity bone cement is 4-6 mL while the optimal volume of high-viscosity bone cement is 6-8 mL.
本研究旨在评估不同黏度和骨水泥体积的经皮椎体成形术治疗骨质疏松性椎体压缩性骨折（OVCFs）的疗效和并发症。
本研究回顾性分析了 2014 年 1 月至 2019 年 12 月在我院接受单一胸腰椎（T12-L2）OVCF 治疗的 307 例患者。根据骨水泥的不同黏度（I：低黏度骨水泥；II：高黏度骨水泥）和注射体积（A：2-4 mL；B：4-6 mL；C：6-8 mL）将患者分为 6 组。收集患者术前、术后 2 天和末次随访时的视觉模拟评分、局部后凸角、椎体前缘高度比、骨水泥渗漏和椎体再塌陷率等临床和影像学特征，以评估各组的疗效和并发症。
在疗效方面，两种骨水泥之间无显著差异。注射>4 mL 骨水泥可使患者的临床指标得到良好改善，且椎体再塌陷率较低。注射 6-8 mL 骨水泥可使影像学指标略有改善。然而，当低黏度骨水泥体积超过 6 mL 时，其渗漏率显著增加。当高黏度骨水泥的体积为 6-8 mL 时，渗漏率无明显增加。
综上所述，对于治疗单一胸腰椎 OVCFs，推荐低黏度骨水泥的注射体积为 4-6 mL，高黏度骨水泥的最佳注射体积为 6-8 mL。
