Peng Junmu, Qin Jie, Huang Tianji, Luo Xiaoji, Zhong Weiyang, Quan Zhengxue
Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People's Republic of China.
Department of Orthopedic Surgery, The Ninth People's Hospital of Chongqing, Chongqing, 400799, People's Republic of China.
J Pain Res. 2021 Dec 31;14:3951-3959. doi: 10.2147/JPR.S345760. eCollection 2021.
BACKGROUND: A retrospective study aimed to introduce a new method for improving the diffusion degree of bone cement and to observe its clinical efficacy in percutaneous vertebroplasty treating osteoporotic vertebral compression fractures (OVCFs). METHODS: From January 2019 to March 2020, a total of 83 patients were enrolled and reviewed. The patients were divided into two groups according to the operation method. The clinical and radiographic parameters were recorded and compared between these two groups. Those who received percutaneous vertebroplasty with haemorrhage aspiration were recorded as group A (n=42). In group A, the haemorrhage in the vertebral fracture was aspirated compared with conventional percutaneous vertebroplasty. Patients who underwent conventional percutaneous vertebroplasty were classified as group B (n=41). RESULTS: Visual analogue scale (VAS) values and Oswestry Disability Index (ODI) scores showed no significant difference between the two groups preoperatively, postoperatively or at the final follow-up (FU) (P>0.05). The intraoperative VAS score (bone cement injection) in group A was significantly lower than that in group B (3.83±0.79 vs 5.44±1.32, P < 0.01). The local kyphotic angle (LKA) (final follow-up), LKA loss, fractured vertebral anterior height loss (FVAHL) and anterior vertebral height loss ratio (AVHLR) were significantly lower in group A than in group B. The anterior vertebral height ratio (AVHR) at the final FU in group A was higher than that in group B (P=0.013). The distribution of bone cement was significantly different (P=0.034). By analysing the distribution pattern of bone cement, it was found that the values of LKA loss, FVAHL and AVHLR were superior in the type A bone cement distribution to those in types B and C. CONCLUSION: Compared with traditional surgical methods, bone haemorrhage aspiration could improve the diffusion degree of bone cement and reduce the height loss and deformity of injured vertebrae. This method provides a feasible new scheme for improving the dispersion of bone cement.
背景：一项回顾性研究旨在引入一种提高骨水泥弥散程度的新方法，并观察其在经皮椎体成形术治疗骨质疏松性椎体压缩骨折（OVCFs）中的临床疗效。 方法：2019年1月至2020年3月，共纳入83例患者并进行回顾性分析。根据手术方法将患者分为两组。记录并比较两组的临床和影像学参数。接受带出血抽吸的经皮椎体成形术的患者记录为A组（n = 42）。在A组中，与传统经皮椎体成形术相比，对椎体骨折内的出血进行了抽吸。接受传统经皮椎体成形术的患者归为B组（n = 41）。 结果：视觉模拟评分（VAS）值和Oswestry功能障碍指数（ODI）评分在术前、术后或末次随访（FU）时两组之间均无显著差异（P>0.05）。A组术中VAS评分（骨水泥注入时）显著低于B组（3.83±0.79 vs 5.44±1.32，P < 0.01）。A组末次随访时的局部后凸角（LKA）、LKA丢失、骨折椎体前缘高度丢失（FVAHL）和前缘高度丢失率（AVHLR）均显著低于B组。A组末次随访时的前缘高度比（AVHR）高于B组（P = 0.013）。骨水泥分布有显著差异（P = 0.034）。通过分析骨水泥分布模式发现，A型骨水泥分布时LKA丢失、FVAHL和AVHLR的值优于B型和C型。 结论：与传统手术方法相比，骨出血抽吸可提高骨水泥弥散程度，减少受伤椎体的高度丢失和畸形。该方法为改善骨水泥弥散提供了一种可行的新方案。
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