经皮椎体成形术后骨水泥分布对疗效的影响：一项回顾性匹配队列研究。
Influence of bone cement distribution on outcomes following percutaneous vertebroplasty: a retrospective matched-cohort study.
机构信息
Department of Spinal Surgery, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
The First School of Clinical Medicine of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
出版信息
J Int Med Res. 2021 Jul;49(7):3000605211022287. doi: 10.1177/03000605211022287.
OBJECTIVE
To evaluate the influence of insufficient bone cement distribution on outcomes following percutaneous vertebroplasty (PVP).
METHODS
This retrospective matched-cohort study included patients 50-90 years of age who had undergone PVP for single level vertebral compression fractures (VCFs) from February 2015 to December 2018. Insufficient (Group A)/sufficient (Group B) distribution of bone cement in the fracture area was assessed from pre- and post-operative computed tomography (CT) images. Assessments were before, 3-days post-procedure, and at the last follow-up visit (≥12 months).
RESULT
Of the 270 eligible patients, there were 54 matched pairs. On post-operative day 3 and at the last follow-up visit, significantly greater visual analogue scale (VAS) pain scores and Oswestry Disability Index (ODI) scores were obtained in Group B over Group A, while kyphotic angles (KAs) and vertebral height (VH) loss were significantly larger in Group A compared with Group B. Incidence of asymptomatic cement leakage and re-collapse of cemented vertebrae were also greater in Group A compared with Group B.
CONCLUSIONS
Insufficient cement distribution may relate to less pain relief and result in progressive vertebral collapse and kyphotic deformity post-PVP.
目的
评估经皮椎体成形术（PVP）后骨水泥分布不足对疗效的影响。
方法
本回顾性匹配队列研究纳入了 2015 年 2 月至 2018 年 12 月因单个椎体压缩性骨折（VCF）接受 PVP 治疗的 50-90 岁患者。从术前和术后 CT 图像评估骨折区域骨水泥的不足（A 组）/充足（B 组）分布情况。评估时间分别为术前、术后 3 天和末次随访（≥12 个月）。
结果
在 270 名符合条件的患者中，有 54 对匹配。在术后 3 天和末次随访时，B 组的视觉模拟评分（VAS）疼痛评分和 Oswestry 功能障碍指数（ODI）评分明显高于 A 组，而 A 组的后凸角（KA）和椎体高度（VH）丢失明显大于 B 组。A 组无症状性水泥渗漏和水泥固定椎体再塌陷的发生率也明显高于 B 组。
结论
骨水泥分布不足可能与缓解疼痛效果较差有关，并导致 PVP 后椎体进行性塌陷和后凸畸形。
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