【摘要】 目的探讨骨水泥填充剂量对PKP手术治疗骨质疏松椎体压缩性骨折(osteoporotic vertebral compression fractures,OVCF)疗效的影响。方法选取我院2012-06-2017-06,行PKP手术的150例OVCF患者作为研究对象,根据术中骨水泥填充剂量的不同将所有入选病例分为低剂量组(2-3 ml,A组)、常规剂量组(3-5 ml,B组)、高剂量组(5-6.5 ml,C组)各50例,分别比较3组患者术前、术后各时间的椎体前缘高度、后凸Cobb角、ODI评分,统计各组患者术后并发症发生情况。结果 3组患者术后3 d、2年的椎体前缘高度均较术前明显增加,Cobb角均较术前明显降低,术后1个月、2年的ODI评分亦明显低于术前(P均<0.05);术后3组组间各观察时间的椎体前缘高度、Cobb角及ODI评分差异均无统计学意义(P>0.05);其中A组骨水泥渗漏发生率为4.00%,显著低于B组的18.00%及C组的24.00%,组间差异有统计学意义(x~2=5.005、8.306,P=0.025、0.004);B、C组之间差异无统计学意义(x~2=0.542,P=0.461)。随访2年,3组腰背疼痛改善率达84%以上,A组无再骨折发生,B组出现1例,C组出现4例,但组间再骨折发生情况相比较,差异无统计学意义(x~2=5.379,P=0.068)。结论不同剂量骨水泥经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折均临床有效,术后患者腰背痛及术后再骨折发生率低,其中低剂量骨水泥在降低患者术后骨水泥渗漏发生方面更为突出,其对于促进患者术后康复具有重要意义。更多还原

【Abstract】 Objective To explore the effect of the percutaneous kyphoplasty with different doses of bone cement in the treatment of osteoporotic vertebral compression fractures and the difference of postoperative complications of re fracture and lumbago and back pain. Methods 150 cases of osteoporotic vertebral compression fractures treated in our hospital in June 2012 ～June 2017 were selected as the research subjects, all patients were treated with PKP, and all the selected cases were divided into low dose group(group A), routine dose group(group B), and high dose group(group C) according to the dosage of bone cement injection,50 cases in each group. The height of the anterior edge of the vertebral body, the Cobb angle of the kyphosis and the ODI score were compared between the three groups of patients before and after the operation. The leakage of bone cement after the operation was statistically analyzed.The pain improvement and the occurrence of re fracture were statistically analyzed in the follow-up period of 2 years. Results The height of the anterior edge of the vertebral body in the three groups was significantly increased at 3 days and 2 years after operation,and the Cobb angle was significantly lower than that before the operation, and the ODI score of 1 month～2 years after operation was significantly lower than that before the operation(P <0.05). There was no statistically significant difference in the height of anterior vertebral body, Cobb angle and ODI score between the three groups after operation(P>0.05).The incidence of bone cement leakage in group A was 4% significantly lower than that 18% in group B and 24% in group C,The difference between groups was statistically significant(x~2=5.005、8.306,P=0.025、0.004), and there was no statistical difference between group B and C(x~2=0.542,P=0.461). After2 years of follow-up, the improvement rate of lumbago and backache in the three groups was over 84%, and there was no re fracture in group A, there were 1 cases in group B and 4 cases in group C, but there was no significant difference in the incidence of re fracture between groups(x~2=5.379, P=0.068). Conclusion Percutaneous kyphoplasty with different doses of bone cement is effective in the treatment of osteoporotic vertebral compression fractures. The incidence of low back pain and post-operative re-fracture is low. Among them, low doses of bone cement are more prominent in reducing the occurrence of post-operative cement leakage, which is of great significance for promoting the rehabilitation of patients.更多还原