摘要
目的探讨经皮椎体成形术(PVP)骨水泥在骨折椎体内的弥散情况及其对再发骨折的影响。方法回顾性分析2012年1月至2014年3月因胸腰椎骨质疏松性椎体压缩骨折(OVCF)行PVP治疗并且随访资料完整患者276例,根据术后复查的X线和CT判断骨水泥在骨折椎体内的弥散情况,将患者分为骨水泥弥散充分组(A组)100例,骨水泥弥散不佳组(B组)176例。记录患者术前、术后3d和终末随访的视觉模拟评分(VAS)及强化椎体后凸Cobb角。结果 276例患者均获随访,无严重并发症发生。两组终末随访时Cobb角、VAS比较,差异均有统计学意义(P<0.05);两组术前、术后3d的Cobb角及VAS比较,差异均无统计学意义(P>0.05)。两组再发骨折率分别为7.00%和15.34%,两组比较差异有统计学意义(P<0.05)。结论PVP是治疗OVCF的有效方法,当骨密度相近时,骨水泥弥散不佳可能是术后继发进展性后凸畸形和再发骨折的危险因素。
Objective To research the dispersion situation of bone cement in the fracture vertebral body and its influence on refracture in percutaneous vertebroplasty（PVP）.Methods Two hundred and seventy-six patients with the complete follow-up data in our hospital from January 2012 to March 2014 were analyzed retrospectively,all cases were diagnosed as thoracolumbar osteoporosis vertebral compressional fracture（OVCF）and treated by PVP.According to the bone cement dispersion condition in the fracture vertebral body by the postoperative X-ray and CT,the patients were allocated to the bone cement sufficient diffusing group（group A,100cases）and the bone cement poor diffusing group（group B,176cases）.The VAS scores and the kyphotic Cobb angle were recorded before operation,on postoperative 3dand the final follow-up.Results All the patients were followed up without severe complications occurrence.The VAS scores and the kyphotic Cobb angle before operation,on postoperative 3dand final follow up had no statistically significant differences between the two groups（P0.05）.The refracrure occurrence rates in the two groups were 7.00% and 15.34%respectively,the difference was statistically significant（P0.05）.Conclusion PVP is an effective method for the treatment of OVCF.But when the bone mineral density is similar,bone cement poor dispersion may be a risk factor for postoperative progressive kyphotic deformity and refracture.
出处
《重庆医学》
CAS
北大核心
2016年第6期752-755,759,共5页
Chongqing medicine
基金
广西卫生厅科研课题(Z2014119
Z2013190)
关键词
椎体成形术
骨水泥弥散
骨质疏松性椎体压缩骨折
再发骨折
vertebroplasty
bone cement dispersion
osteoporosis vertebral compression fracture
refracture
