Osteoporotic vertebral compression fractures treated by vertebroplasty with bone cements of different viscosity

doi:10.3969/j.issn.2095-4344.0978

Abstract

Abstract:

BACKGROUND: Vertebroplasty is one of the effective methods for minimally invasive treatment of osteoporotic vertebral compression fractures. Bone cement as the most commonly used filling material is disputed on its clinical effects of different viscosity.

OBJECTIVE: To compare the efficacy and safety of different viscosity bone cement vertebroplasty in the treatment of osteoporotic vertebral compression fractures.

METHODS: One hundred and eighty-three patients with osteoporotic vertebral compression fracture were randomly divided into four groups: percutaneous vertebroplasty with high viscosity bone cement group (group A), percutaneous vertebroplasty with low viscosity bone cement group (group B), percutaneous kyphoplasty with high viscosity bone cement group (group C), and percutaneous kyphoplasty with low viscosity bone cement group (group D).

RESULTS AND CONCLUSION: (1) The operative time and X-ray exposure time were longer in the two low viscosity bone cement groups than the two corresponding high viscosity bone cement groups, respectively. (2) After operation, visual analogue scale scores and disability index scores were gradually decreased in the all the groups. Compared with the group A, the visual analogue scale score and disability index score were lower in the group C; compared with group B, the visual analogue scale score and disability index score were lower in the group D. (3) After operation, the kyphosis Cobb angle was gradually reduced and the sagittal index of injured vertebrae were gradually increased in all the groups. The postoperative Cobb angle value was ranked as follows: group A > group C > group D. (4) Compared with two low viscosity bone cement groups, two high viscosity bone cement group had lower incidence of adverse events. These findings indicate that high viscosity bone cement has better safety and effectiveness in the treatment of osteoporotic vertebral compression fractures. The clinical efficacy of percutaneous kyphoplasty with high viscosity bone cement is the best among the four systems.

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: Osteoporotic Fractures, Vertebroplasty, Tissue Engineering

CLC Number:

R318

Liu Yang. Osteoporotic vertebral compression fractures treated by vertebroplasty with bone cements of different viscosity[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(30): 4774-4781.

Figures/Tables 4

2.4 后凸Cobb角及伤椎的矢状面指数结果显示，各组置入后1周、3个月、1年后凸Cobb角及伤椎的矢状面指数与置入前相比差异有显著性意义(P < 0.01)；置入后1周各组后凸Cobb角与置入后3个月相比差异有显著性意义(P < 0.01)；置入后3个月各组后凸Cobb角与置入后1年相比差异有显著性意义(P < 0.01)；置入后1周、3个月、1年经皮椎体成形高黏度骨水泥组后凸Cobb角与经皮椎体后凸成形高黏度骨水泥组相比差异有显著性意义(P < 0.05)；置入后1周和1年经皮椎体成形高黏度骨水泥组后凸Cobb角与经皮椎体后凸成形低黏度骨水泥组相比差异有显著性意义(P < 0.05)；置入后1周、3个月、1年B组后凸Cobb角与经皮椎体后凸成形低黏度骨水泥组相比差异有显著性意义 (P < 0.05)；置入后1周、3个月、1年经皮椎体成形高黏度骨水泥组后凸Cobb角及伤椎的矢状面指数与经皮椎体成形低黏度骨水泥组相比差异无显著性意义(P > 0.05)；置入后1周、3个月、1年C组后凸Cobb角及伤椎的矢状面指数与经皮椎体后凸成形低黏度骨水泥组相比差异无显著性意义(P > 0.05)；置入前、置入后1周、3个月、1年各组伤椎的矢状面指数相比差异无显著性意义(P > 0.05)，见表4。 2.5 并发症发生情况与骨水泥渗漏发生率结果显示，经皮椎体成形高黏度骨水泥组47例患者64个椎体中有1个椎体发生椎体皮质渗漏、1个椎体发生终板渗漏、2个椎体发生椎旁血管渗漏，渗漏发生率为6%；经皮椎体成形低黏度骨水泥组46例患者68个椎体中有4个椎体发生椎体皮质渗漏、2个椎体发生终板渗漏、4个椎体发生椎旁血管渗漏、1个椎体发生椎管内渗漏，渗漏发生率为16%；经皮椎体后凸成形高黏度骨水泥组44例患者66个椎体中有1个椎体发生椎体皮质渗漏、1个椎体发生终板渗漏、1个椎体发生椎旁血管渗漏，渗漏发生率为5%；经皮椎体后凸成形低黏度骨水泥组46例患者67个椎体中有5个椎体发生椎体皮质渗漏、1个椎体发生终板渗漏、3个椎体发生椎旁血管渗漏、1个椎体发生椎管内渗漏，渗漏发生率为15%。各组患者均未出现神经损伤症状、再次骨折或相邻椎体继发骨折、骨水泥肺栓塞和椎管狭窄。经皮椎体成形高黏度骨水泥组骨水泥渗漏发生率与经皮椎体后凸成形高黏度骨水泥组相比有显著性意义(P < 0.05)；经皮椎体成形低黏度骨水泥组骨水泥渗漏发生率与经皮椎体后凸成形低黏度骨水泥组相比有显著性意义(P < 0.05)；经皮椎体成形高黏度骨水泥组骨水泥渗漏发生率与经皮椎体成形低黏度骨水泥组相比无显著性意义(P > 0.05)；经皮椎体后凸成形高黏度骨水泥组骨水泥渗漏发生率与经皮椎体后凸成形低黏度骨水泥组相比无显著性意义(P > 0.05)。"

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