【摘要】 目的探讨高粘度骨水泥椎体成形术在骨质疏松性椎体压缩性骨折中的临床应用价值。方法选取自2013年10月至2016年12月北京市垂杨柳医院收治的骨质疏松性椎体压缩性骨折患者100例,将患者随机分为低粘度骨水泥组(n=50)和高粘度骨水泥组(n=50)。低粘度骨水泥组应用低粘度聚甲基丙烯酸甲酯骨水泥行椎体成形,高粘度骨水泥组应用高粘度丙烯酸类树脂骨水泥。随访60 d,比较两组手术时间、骨水泥注射量、骨水泥泄漏发生率、椎体高度、后凸Cobb角、视觉模拟评分(VAS)、Oswestry功能障碍指数问卷表(ODI)指数。结果两组手术时间比较,差异无统计学意义(P>0.05);高粘度骨水泥组骨水泥注射量为(2.903±0.702)ml,多于低粘度骨水泥组的(2.301±0.563)ml,差异有统计学意义(P<0.05);高粘度骨水泥组骨水泥泄漏发生率为2.0%(1/50),低于低粘度骨水泥组的12.0%(6/50),差异有统计学意义(P<0.05);两组术前椎体高度和后凸Cobb角比较,差异无统计学意义(P>0.05);高粘度骨水泥组术后椎体高度为(23.422±3.429)mm,高于低粘度骨水泥组的(20.902±3.142)mm,后凸Cobb角为(12.032°±2.011°),小于低粘度骨水泥组的(13.487°±2.143°),差异均有统计学意义(P<0.05);两组术前和术后1、60 d的VAS评分和ODI指数比较,差异均无统计学意义(P>0.05)。结论高粘度骨水泥椎体成形术在骨质疏松性椎体压缩性骨折治疗中的优势主要体现在避免骨水泥泄露和恢复椎体高度明显方面,临床疗效满意。更多还原

【Abstract】 Objective To investigate the clinical effect of high viscosity bone cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures. Methods A retrospective study was performed on 100 cases of patients with osteoporotic vertebral compression fractures who were admitted from October 2013 to December 2016. Patients were randomly divided into the low viscosity bone cement group( n =50) and high viscosity bone cement group( n =50). The vertebral body in the low viscosity bone cement group was formed by low viscosity polymethyl methacrylate bone cement,which was formed by high viscosity acrylic resin bone cement in the high viscosity bone cement group. Patients were followed up for 60 days,the operation time,bone cement injection volume,incidence of bone cement leakage,vertebral height,kyphosis Cobb angle,VAS score and ODI index were compared between the both groups. Results There was no significant difference between the two groups in operation time comparison( P > 0. 05). Bone cement injection in the high viscosity group( 2. 903 ± 0. 702) ml was more than( 2. 301 ± 0. 563) ml of the low viscosity bone cement group( P < 0. 05). The incidence of bone cement leakage in the high viscosity group 2. 0%( 1/50) was lower than 12. 0%( 6/50) in the low viscosity bone cement group( P < 0. 05). There was no statistically significant difference in preoperative vertebral height and the kyphosis Cobb angle between the two groups( P > 0. 05). The preoperative vertebral height in the high viscosity bone cement group( 23. 422 ± 3. 429) mm was higher than( 20. 902 ± 3. 142) mm in the low viscosity bone cement group; the kyphosis Cobb angle in the high viscosity bone cement group( 12. 032° ± 2. 011°) was smaller than( 13. 487° ± 2. 143°) in the low viscosity bone cement group( P < 0. 05). There was no statistically significant difference in VAS score and ODI index before surgery,1 day and 60 days after surgery( P > 0. 05). Conclusion The treatment of vertebral compression fracture with high viscosity bone cement is superior to the low viscosity bone cement in the recovery of the compressed vertebral height and the avoidance of bone cement leakage,and the clinical effect is satisfactory.更多还原