Curative effects of three filling materials in the treatment of osteoporotic thoracolumbar fractures

doi:10.3969/j.issn.2095-4344.1554

Abstract

Abstract:

BACKGROUND: In the treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty, the choice of filling material has become an important factor for the surgical outcome.

OBJECTIVE: To investigate the effects of polymethyl methacrylate (PMMA), calcium phosphate cement (CPC) and CPC with recombinant human bone morphogenetic protein-2 (rhBMP-2/CPC) in the treatment of osteoporotic vertebral compression fractures.

METHODS: One hundred and twenty patients with osteoporotic thoracolumbar compression fractures undergoing percutaneous kyphoplasty were included, and were randomly divided into three groups, PMMA, CPC and rhBMP-2/CPC groups (n=40 per group). After 7 days of treatment, the clinical efficacy of each group was evaluated. The use of analgesics was evaluated before and 3 months after treatment. Bone mineral density was assessed before treatment and 3 and 6 months after treatment. At 1 year after treatment, the incidence of new fractures was counted.

RESULTS AND CONCLUSION: The total effective rate of the three groups was 97.5%, and there was no significant difference in the clinical efficacy among groups (P > 0.05). The visual analogue scale scores in each group after 7-day treatment were all improved compared with the baseline (P < 0.05). The improvement in the CPC and rhBMP-2/CPC groups was significantly better than that in the PMMA group (P < 0.05). There was no difference in the improvement between CPC and rhBMP-2/CPC groups (P > 0.05).The recovery of motor function in the three groups at 7 days after treatment was significantly better than the baseline (P < 0.05). The improvement degree in the CPC and rhBMP-2/CPC groups was significantly better than that in the PMMA group (P < 0.05). The height of the injured anterior and middle vertebral column and the Cobb angle of kyphosis in each group at 7 days after treatment were significantly improved compared with the baseline (P < 0.05).There was no significant difference in the degree of improvement among groups (P > 0.05). At 3 months after treatment, the patients in all groups were separated from the analgesic drugs. At 6 months after treatment, the bone mineral density in the PMMA and CPC groups showed no significant difference compared with the baseline (P > 0.05). The bone mineral density in the rhBMP-2/CPC group was significantly increased compared with the baseline (P < 0.05). After 1 year of treatment, the incidence of new fractures in the CPC and rhBMP-2/CPC groups was significantly lower than that in the PMMA group (P < 0.05), and there was no difference between CPC and rhBMP-2/CPC groups (P >0.05). These results suggest that the clinical efficacy of PMMA, CPC and rhBMP-2/CPC in the treatment of osteoporotic vertebral compression fractures is satisfactory. CPC and rhBMP-2/CPC can accelerate pain relief and hold long-term support effect, reduce the incidence of new fractures, and meanwhile, rhBMP-2/CPC can increase the vertebral mineral density.

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

Key words: Calcium Phosphates, Bone Morphogenetic Proteins, Spinal Fractures, Osteoporotic Fractures, Tissue Engineering

CLC Number:

R459.9

Wang Xuefeng, Shang Xifu . Curative effects of three filling materials in the treatment of osteoporotic thoracolumbar fractures[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(6): 863-869.

Figures/Tables 8

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