中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (26): 6826-6832.doi: 10.12307/2026.762

• 组织工程骨材料 tissue-engineered bone • 上一篇    下一篇

经皮椎体成形与椎体后凸成形治疗中骨水泥弥散高度的定量分析和疗效比较

马在超1，2，麦麦提依不巴吉·阿不都卡迪尔2，3，杨增强1，2，李  标1，2，张  峥2，崔  泳2   

  1. 1新疆医科大学，新疆维吾尔自治区乌鲁木齐市  830054；2新疆医科大学第五附属医院，新疆维吾尔自治区乌鲁木齐市  830011；3中国医学科学院北京协和医院骨科，北京市  100730
  • 接受日期:2025-09-30 出版日期:2026-09-18 发布日期:2026-03-11
  • 通讯作者: 崔泳，硕士，主任医师，副教授，硕士生导师，新疆医科大学第五附属医院骨科中心，新疆维吾尔自治区乌鲁木齐市 830011 张峥，硕士，副主任医师，硕士生导师，新疆医科大学第五附属医院脊柱外科，新疆维吾尔自治区乌鲁木齐市 830011
  • 作者简介:马在超，男，1999年生，山东省青岛市人，汉族，新疆医科大学在读硕士，主要从事生物骨组织工程等相关研究。

Quantitative analysis of bone cement dispersion height and efficacy comparison in percutaneous vertebroplasty and percutaneous kyphoplasty

Ma Zaichao1, 2, Maimaitiyibubaji·Abudukadier2, 3, Yang Zengqiang1, 2, Li Biao1, 2, Zhang Zheng2, Cui Yong2   

  1. 1Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China; 2Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China; 3Department of Orthopedics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100730, China
  • Accepted:2025-09-30 Online:2026-09-18 Published:2026-03-11
  • Contact: Cui Yong, MS, Chief physician, Associate professor, Master's supervisor, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China Zhang Zheng, MS, Associate chief physician, Master's supervisor, Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China
  • About author:Ma Zaichao, MS candidate, Xinjiang Medical University, Urumqi 830054, Xinjiang Uygur Autonomous Region, China; Fifth Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, Xinjiang Uygur Autonomous Region, China

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摘要：

文题释义：
经皮椎体成形：一种影像学实时引导的微创介入技术，通过经皮椎弓根穿刺向责任椎体内注入骨水泥，利用骨水泥聚合后机械支撑效应稳定骨折椎体、缓解疼痛并重建脊柱生物力学功能。
经皮椎体后凸成形：一种基于经皮椎体成形的改良微创介入技术，通过在椎体内置入可膨胀球囊，扩张复位塌陷椎体并形成空腔后注入骨水泥，实现椎体高度部分恢复、脊柱后凸畸形矫正及生物力学稳定性重建。

背景：研究表明，骨质疏松性椎体压缩骨折患者预后转归存在显著的个体差异，潜在机制与手术术式的选择、骨水泥在椎体内的分布特征以及伤椎高度复位程度密切相关。
目的：探讨经皮椎体成形与椎体后凸成形手术治疗骨质疏松性椎体压缩骨折中的骨水泥弥散高度差异。
方法：纳入2019年5月至2025年2月新疆医科大学第五附属医院收治的单节段骨质疏松性椎体压缩骨折患者112例，按手术方式分为经皮椎体成形组(n=57)与经皮椎体后凸成形组(n=55)，比较两组患者术后6个月的目测类比评分、Oswestry 功能障碍指数、伤椎局部后凸角与并发症发生率，比较两组椎体前柱、中柱的骨水泥弥散高度以及椎体骨水泥最大弥散高度，采用Pearson相关系数分析骨水泥弥散高度与术后6个月Oswestry 功能障碍指数的相关性。
结果与结论：①两组术后6个月的目测类比评分、Oswestry 功能障碍指数、伤椎局部后凸角均低于术前(P < 0.05)；术后6个月，经皮椎体后凸成形组测类比评分、Oswestry 功能障碍指数、伤椎局部后凸角均低于经皮椎体成形组(P < 0.05)，两组骨水泥渗漏率与邻近椎体骨折发生率比较差异无显著性意义(P > 0.05)；②经皮椎体后凸成形组椎体前柱、中柱的骨水泥弥散高度以及椎体最大弥散高度均高于经皮椎体成形组(P < 0.05)；③Pearson相关系数分析显示，经皮椎体成形组、经皮椎体后凸成形组椎体前柱骨水泥弥散高度、椎体骨水泥最大弥散高度与术后6个月Oswestry功能障碍指数存在显著负相关(r=-0.730，P < 0.001；r=-0.700，P < 0.001；r=-0.581，P < 0.001；r=-0.468，P < 0.001)，两组椎体中柱骨水泥弥散高度与术后6个月Oswestry功能障碍指数无明显相关性( r=-0.089，P < 0.520；r=-0.024，P < 0.859)；④结果表明，骨水泥在椎体内的三维弥散高度可作为评估经皮椎体成形与椎体后凸成形手术疗效的潜在影像学预测因子。
https://orcid.org/0009-0005-9766-2696(马在超)

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料；口腔生物材料；纳米材料；缓释材料；材料相容性；组织工程

关键词: 骨质疏松骨折, 经皮椎体成形, 经皮椎体后凸成形, 骨水泥三维弥散, 定量分析, 骨水泥弥散高度

Abstract: BACKGROUND: Studies have shown that patients with osteoporotic vertebral compression fractures exhibit significant individual differences in prognostic outcomes. The underlying mechanisms are closely associated with the choice of surgical technique, the distribution characteristics of bone cement within the vertebral body, and the degree of height restoration of the injured vertebra.
OBJECTIVE: To explore the difference in bone cement dispersion height between percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fractures.
METHODS: A total of 112 patients with single-segment osteoporotic vertebral compression fractures admitted to the Fifth Affiliated Hospital of Xinjiang Medical University from May 2019 to February 2025 were included. They were divided into a percutaneous vertebroplasty group (n=57) and a percutaneous kyphoplasty group (n=55) based on the surgical procedure. The visual analog scale score, Oswestry Disability Index, local kyphotic angle of the injured vertebra, and complication rates were compared between the two groups at 6 months postoperatively. The bone cement dispersion heights in the anterior and middle columns of the vertebral body, as well as the maximum dispersion height, were also compared between the two groups. Pearson correlation analysis was used to evaluate the relationship between bone cement dispersion height and the Oswestry Disability Index at 6 months after surgery.
RESULTS AND CONCLUSION: (1) At 6 months postoperatively, the visual analog scale score, Oswestry Disability Index, and local kyphotic angle were significantly lower than preoperative values in both groups (P < 0.05). At 6 months after surgery, the percutaneous kyphoplasty group showed significantly lower visual analog scale scores, Oswestry Disability Index, and local kyphotic angle compared with the percutaneous vertebroplasty group (P < 0.05). There was no significant difference in the rates of bone cement leakage or adjacent vertebral fracture between the two groups (P > 0.05). (2) The bone cement dispersion heights in the anterior and middle columns, as well as the maximum dispersion height, were significantly greater in the percutaneous kyphoplasty group than in the percutaneous vertebroplasty group (P < 0.05). (3) Pearson correlation analysis revealed a significant negative correlation between the anterior column bone cement dispersion height (and maximum dispersion height) and the Oswestry Disability Index at 6 months postoperatively (r=-0.730, P < 0.001; r=-0.700, P < 0.001; r=-0.581, P < 0.001; r=-0.468, P < 0.001). No significant correlation was found between the middle column bone cement dispersion height and the Oswestry Disability Index at 6 months postoperatively (r=-0.089, P < 0.520; r=-0.024, P < 0.859). (4) The results indicate that the three-dimensional dispersion height of bone cement within the vertebral body can serve as a potential imaging predictor for evaluating the efficacy of percutaneous vertebroplasty and percutaneous kyphoplasty. 

Key words: osteoporotic fractures, percutaneous vertebroplasty, percutaneous kyphoplasty, three-dimensional dispersion of bone cement, quantitative

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