Abstract:

BACKGROUND: Previous studies show that the amount and diffusion degree of bone cement in vertebroplasty have some influence on the postoperative recovery of patients with osteoporotic vertebral compression fracture, but there are few reports about the correlation between the amount and diffusion degree of bone cement in vertebroplasty and the recovery of vertebral body.

OBJECTIVE: To investigate the relationships between the effect of percutaneous vertebroplasty on osteoporotic vertebral compression fractures and the injection amount and dispersion degree of bone cement.

METHODS: Totally 102 osteoporotic vertebral compression fracture patients (109 vertebrae) who received treatment in the Sanya Hospital of Traditional Chinese Medicine from January 2017 to August 2018, including 42 males and 60 females at the age of 52-76 years, were retrospectively analyzed. All patients received percutaneous vertebroplasty. According to the injection amount of bone cement, they were divided into two groups: observation group 1 (injection > 4 mL, n=57) and control group 1 (injection ≤ 4 mL, n=45). According to the degree of dispersion of bone cement, they were divided into two groups: observation group 2 (filling rate > 15%, n=61) and control group 2 (filling rate ≤ 15%, n=41). Visual analogue scale score, Oswestry disability index, anterior vertebral height, Cobb angle, and the occurrence of cement leakage were observed before and after surgery. The correlations of the injection amount and dispersion degree of bone cement with the height of vertebral body recovered were analyzed. This study was approved by the Medical Ethics Committee of Sanya Hospital of Traditional Chinese Medicine.

RESULTS AND CONCLUSION: (1) The visual analogue scale score and Oswestry dysfunction index of patients in the observation group 1 and control group 1 at 3 days after operation were decreased compared with before operation (P < 0.05), while those in the observation group 1 were lower than those in the control group 1 (P < 0.05). The visual analogue scale score and Oswestry disability index were decreased in the observation group 2 and control group 2 at 3 days after operation compared with before operation (P < 0.05), while those of the observation group 2 were lower than those of the control group 2 (P < 0.05). (2) The anterior height of vertebral body and the Cobb angle in the observation group 1 and control group 1 at 3 days after operation were improved than those before operation (P < 0.05), while those in observation group 1 were better than those in control group 1 (P < 0.05). The anterior height of vertebral body and the Cobb angle in observation group 2 and control group 2 at 3 days after operation were improved than those before operation (P < 0.05), while those in observation group 2 were better than those in control group 2 (P < 0.05). (3) There was no significant difference in the incidence of cement leakage between observation group 1 and control group 1 (P > 0.05). There was no significant difference in the incidence of cement leakage between observation group 2 and control group 2 (P > 0.05). (4) The height of vertebral body recovery was positively correlated with the injection amount and dispersion degree of bone cement (P < 0.05). (5) The results suggest that increases of the injection amount and dispersion degree of bone cement properly can alleviate the pain, improve the mobility, correct the deformity of vertebral posterior concave, and restore the height of vertebral body of osteoporotic vertebral compression fracture patients. The injection amount and dispersion degree of bone cement are positively correlated with the recovery height of vertebral body.  

Key words: bone cement, osteoporotic vertebral compression fracture, vertebroplasty, bone cement injection amount, dispersion degree, correlation, vertebral recovery height, Cobb angle