Bone filling mesh container versus balloon percutaneous kyphoplasty repairs osteoporotic vertebral compressive fracture

doi:10.3969/j.issn.2095-4344.2016.52.015

Abstract

Abstract:

BACKGROUND: It remains controversial about the clinical outcomes of bone filling mesh containers (BFMCs) and percutaneous kyphoplasty (PKP) in pain relief, kyphosis correction, vertebral height restoration and reduction of cement leakage.
OBJECTIVE: To compare the clinical outcomes of BFMCs and PKP for osteoporotic vertebral compressive fracture.
METHODS: A total of 90 patients with osteoporotic vertebral compressive fracture were equivalently randomized into two groups, followed by treated with BFMCs or PKP, respectively. During a more than 3-month follow-up, pain relief, kyphotic angle, the vertebral height and cement leakage were observed in the two groups to assess the therapeutic effects.
RESULTS AND CONCLUSION: Pain in all patients was relieved at 24 hours after operation. There was no significant difference in pain relief between two groups (P > 0.05). PKP was more effective to restore the vertebral height (P < 0.05), while BMCFs significantly reduced the leakage rate of bone cement (P < 0.05). These results suggest that BFMCs and PKP have their own advantages in the treatment of osteoporotic vertebral compressive fracture, but both exert analgesic effects.

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: Tissue Engineering, Biocompatible Materials, Osteoporosis

CLC Number:

R318

Fu Guo-yong, Geng Xiao-peng, Wang Xia, Li Xue-cheng, Gao Sheng, Niu Chong, Dou Yong-feng, Zhu Kai.

Bone filling mesh container versus balloon percutaneous kyphoplasty repairs osteoporotic vertebral compressive fracture

[J]. Chinese Journal of Tissue Engineering Research, 2016, 20(52): 7858-7864.

Figures/Tables 7

2.4 两组治疗前后在目测类比评分、Cobb角椎体高度与骨水泥渗漏方面对比两组术前术后组内指标比较：目测类比评分、Cobb角，椎体高度手术前后比较均差异有显著性意义(P < 0.05)。提示两组术后较术前在缓解疼痛、纠正后凸畸形和恢复椎体高度方面疗效显著。说明两种手术对于骨质疏松性椎体压缩性骨折患者在缓解疼痛、纠正后凸畸形和恢复椎体高度方面作用疗效确切，达到了治疗的目的。术后7 d，1个月，末次随访在目测类比评分和Cobb角方面差异无显著性意义(P > 0.05)。提示术后即时疗效与恢复期疗效相似，说明近期效果满意，术后恢复期在疼痛缓解、纠正后凸畸形、恢复椎体高度方面改善效果不明显。两组组间指标比较：两组目测类比评分、?目测类比评分差异无显著性意义(P > 0.05；表3)，提示两组在缓解疼痛方面效果相似，说明两种手术方式都达到了缓解骨质疏松性椎体压缩性骨折患者疼痛的目的，且疗效相似。术后两组Cobb角、椎体高度均差异有显著性意义(P < 0.05)，在恢复椎体高度方面，骨填充网袋组优于椎体后凸成形组(表4，5)，提示经皮椎体后凸成形组在恢复椎体高度和纠正椎体后凸畸形方面优于骨填充网袋组，说明在治疗骨质疏松性椎体压缩性骨折恢复椎体高度和纠正椎体后凸畸形方面经皮椎体后凸成形组的疗效优于骨填充网袋组。术后经皮椎体后凸成形组骨水泥渗漏数10例，其中硬膜外骨水泥渗漏3例、椎旁渗漏2例、椎间隙渗漏5例；骨填充网袋组骨水泥渗漏数2例，均为椎间隙渗漏；椎体后凸成形组渗漏数多于骨填充网袋组(P < 0.05；表6)，说明在治疗骨质疏松性椎体压缩性骨折预防骨水泥渗漏方面，骨填充网袋组较经皮椎体后凸成形组作用显著。经皮椎体后凸成形组采用单侧穿刺45个椎体，其中有34个椎体骨水泥越过中线到达对侧，以穿刺侧分布较多；骨填充网袋组单侧穿刺的45个椎体中，有6个见少量骨水泥越过中线到达对侧，大部分椎体骨水泥主要局限在穿刺侧。 "

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