Relationship between bone cement dispersion within pathologic vertebrae and fracture time in vertebroplasty

doi:10.3969/j.issn.2095-4344.2015.52.005

Abstract

Abstract:

BACKGROUND: Vertebroplasty with bone cement injection in treatment of osteoporotic vertebral compression fractures has a positive clinical outcome, but there is a big controversy on the optimal timing of surgery.
OBJECTIVE: To analyze the effect of fracture time on bone cement dispersion within pathologic vertebrae in vertebroplasty treatment.
METHODS: Totally 160 elderly patients with osteoporotic vertebral compression fracture were included, and all were treated with vertebroplasty with high viscosity bone cement injection. According to the duration from fracture to surgery, patients were divided into three groups: fresh fracture group (< 3 weeks), subacute group (3-6 weeks) and old group (> 6 weeks). The bone cement distribution features, diffusion and leakage within the pathologic vertebrae were analyzed by three-dimensional CT image and X-rays.
RESULTS AND CONCLUSION: The bone cement dispersion volume was ranked as fresh group > subacute group > old group, and there was significant difference between groups (P < 0.05). Bone cement dispersion characteristics of each group were uniform distribution with cement-based lumpy shape. The vast majority of bone cement all can disperse to exceed vertebral midline, reaching the upper and lower lamina to a greater degree. Bone cement dispersion coefficient within the pathologic vertebrae of patients in each group was

ranked as fresh group > subacute group > old group, and there was significant difference between groups (P < 0.05). The bone cement leakage rate in the fresh fracture group was significantly lower than that in the subacute and old groups (P < 0.05). These results demonstrate that patients undergoing vertebroplasty within 3 weeks can obtain better bone cement dispersion effect.

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

CLC Number:

R318

Zhu Min, Li Yu-qian, Wang Xiao-dong, Li Hong-bin, Zhang Jian-hua. Relationship between bone cement dispersion within pathologic vertebrae and fracture time in vertebroplasty[J]. Chinese Journal of Tissue Engineering Research, doi: 10.3969/j.issn.2095-4344.2015.52.005.

Figures/Tables 3

References

[1] 杨刘柱,陈仲,严鑫平,等.椎体骨水泥注入联合抗骨质疏松药物治疗急性骨质疏松性椎体压缩性骨折[J].中国组织工程研究, 2014, 18(39):6265-6270.
[2] 查小云,庞晓娜,李锂,等.中老年男性骨质疏松(OP)危险分层与定量超声骨密度(QUS-BMD)及双能X线骨密度(DXA-BMD)的相关性[J].复旦学报:医学版,2014,41(4):504-510.
[3] 王峥嵘,朱昀.老年慢性疾病患者骨质疏松的相关因素分析[J].中华老年医学杂志,2014,33(3):272-275.
[4] 周仁实,刘晓云.经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折的临床疗效[J].中国老年学杂志,2014,34(9):2555-2556.
[5] 孙建民,梁辰.骨质疏松椎体压缩性骨折的临床特征及治疗[J].中华临床医师杂志(电子版),2013,7(19):8555-8559.
[6] 陈书连,王义生,刘宏建,等.椎体成形术和椎体后凸成形术治疗Kummell's病的比较[J].中华实验外科杂志,2012,29(3):523-525.
[7] 陈卫,倪才方,王煊,等.经皮椎体成形术及后凸成形术治疗骨质疏松性椎体压缩骨折的临床对比研究[J].中华放射学杂志, 2011, 45(9):858-862.
[8] 郝定均,刘鹏,贺宝荣,等.陈旧性与新鲜性压缩骨折行椎体成形术的临床对比研究[J].脊柱外科杂志,2012,10(2):83-86.
[9] 李菊根,廖壮文,范子文,等.单侧与双侧椎弓根入路椎体成形术治疗高龄骨质疏松性椎体压缩骨折的临床疗效比较[J].中国微创外科杂志,2013,13(6):531-533.
[10] 江晓兵,莫凌,梁德等.骨水泥在椎体骨折线内弥散情况对椎体成形术治疗效果的影响[J].中国脊柱脊髓杂志,2014,24(2):144-149.
[11] 赵玉波,张庆明.椎体成形术中骨水泥弥散分布等级的量效关系[J].中国骨与关节损伤杂志,2015,30(1):63-65.
[12] 吴强,莫世赞,包拥政,等.椎体成形治疗后骨水泥在椎体内弥散的影响因素[J].中国组织工程研究,2014,18(43):6922-6928.
[13] 包拥政,莫世赞,胡孔和,等.骨折时间对椎体成形术后骨水泥在椎体内弥散的影响[J].广东医学,2015,36(6):890-893.
[14] 张亮,高梁斌,李健,等.椎体成形术中椎体骨密度对骨水泥弥散体积的影响[J].中国脊柱脊髓杂志,2011,21(11):915-918.
[15] 谢志勇,刘训伟,钟建,等.椎体成形过程中磷酸钙骨水泥及可降解网状微孔球囊的应用[J].中国组织工程研究, 2014,18(47): 7566-7572.
[16] 王守宝,王春,林锦,等.老年骨质疏松性胸腰椎压缩性骨折治疗进展[J].临床和实验医学杂志,2010,9(2):153-155.
[17] 黄莹,陶高见,朱彤,等.CT引导下经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效分析[J].中华临床医师杂志(电子版), 2013,7(16):161-162.
[18] Lange A,Kasperk C,Alvares L,et al.Survival and Cost Comparison of Kyphoplasty and Percutaneous Vertebroplasty Using German Claims Data.Spine (Phila Pa 1976). 2013; 39(4): 318-326.
[19] Liu J,Li X,Tang D,et al.Comparing pain reduction following vertebroplasty and conservative treatment for osteoporotic vertebral compression fractures: a meta-analysis of randomized controlled trials.Pain Physician. 2013;16(5): 455-464.
[20] 付咏梅,姚嵩梅.老年骨质疏松症患者发生骨折的影响因素[J].国际护理学杂志,2014,33(9):2336-2337.
[21] 李洪德,何仕诚,张年明等.单发和多发骨质疏松性椎体压缩骨折经椎体成形术治疗后再发骨折的对比分析[J].中国医学影像技术,2010,26(12):2330-2333.
[22] Kim KW,Cho KJ,Kim SW,et al.A nation-wide, outpatient-based survey on the pain, disability, and satisfaction of patients with osteoporotic vertebral compression fractures.Asian Spine J. 2013;7(4):301-307.
[23] Chen D,An ZQ,Song S,et al.Percutaneousvertebroplasty compared with conservative treatment in patients with chronic painful osteoporotic spinal fractures.J Clin Neurosci. 2014; 21(3):473-477.
[24] 陈晓依,刘峰,陈红方,等.老年骨质疏松椎体压缩性骨折患者自我感受负担与生活质量的研究[J].护士进修杂志, 2013,28(6): 486-489.
[25] Lee YK,Jang S,Lee HJ,et al.Mortality after vertebral fracture in Korea: analysis of the National Claim Registry.Osteoporos Int.2012;23(7):1859-1865.
[26] 史光华,李鹏翠,卫小春.骨质疏松椎体压缩骨折的治疗进展[J].中国骨伤, 2013,26(10):878-882.
[27] 卢斌,陈其昕,蒋国强,等.80岁及以上骨质疏松性骨折患者经皮椎体成形术治疗[J].中华老年医学杂志,2010,29(10):829-831.
[28] 白新明.椎体成形术治疗老年骨质疏松性椎体压缩骨折体会[J].河北医药,2010,32(14):1928-1929.
[29] 厉驹,马镇川,易立明,等.椎体后凸成形术手术时机对椎体压缩性骨折近期疗效的影响[J].中医正骨,2011,23(11):38-40.
[30] 刘波,陈国城,邓立平,等.单侧及双侧经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折的对比研究[J].中国医药科学, 2013, 3(14): 185-186,194.
[31] Nieuwenhuijse MJ,Van Erkel AR,Dijkstra PD.Cement leakage in percutaneous vertebroplasty for osteoporotic vertebral compression fractures: identification of risk factor.Spine J. 2011;11(9):839-848.
[32] Clark W,Lyon S,Burnes J.Trials of vertebroplasty for vertebral fractures. N Engl J Med.2009;361(21):2097-2098.
[33] Klazen CA,Lohle PN,de Vries J,et al.Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures(VertosⅡ):an open-label randomized trial.Lancet.2010;376(9746):1085-1092.