论文部分内容阅读
目的比较骨质疏松性椎体压缩骨折磷酸钙骨水泥(calcium phosphate cement,CPC)椎体后凸成形术与聚甲基丙烯酸甲酯骨水泥(polymethylmethacrylate,PMMA)椎体后凸成形术的临床疗效。方法回顾性分析2011年7月至2013年5月,我院进行椎体后凸成形术的治疗的48例骨质疏松性单个椎体压缩骨折患者的临床资料。CPC组23例,其中男9例,女14例,年龄61~82岁,平均69.59岁;PMMA组25例,其中男11例,女14例,年龄67~89岁,平均71.23岁。所有患者在术前、术后即刻、术后3、6、12、24个月进行随访检查。评价比较视觉模拟评分(visual analogue scale,VAS)、止痛药持续使用时间、手术满意度、椎体压缩率、局部后凸畸形及并发症的发生率。结果两组患者的年龄、性别、受伤后至手术的间隔时间差异无统计学意义。术后VAS评分、止痛药持续使用时间、手术满意度、椎体高度恢复及局部后凸畸形两组间差异无统计学意义(P>0.05),均较术前明显好转。继发骨折及骨水泥渗漏两组差异无统计学意义(P>0.05)。CPC组术后3个月及末次随访时椎体压缩率分别为(23.26±10.08)%、(23.39±11.23)%,较术后即刻的(17.22±14.19)%椎体高度有所丢失,差异有统计学意义(P<0.05)。结论对于骨质疏松性椎体压缩骨折行椎体后凸成形术,CPC与PMMA一样安全有效,可以缓解疼痛、提高活动能力,但CPC术后椎体高度恢复后会有部分丢失。
Objective To compare the clinical effects of calcium phosphate cement (CPC) kyphoplasty and polymethylmethacrylate (PMMA) kyphoplasty on osteoporotic vertebral compression fractures. . Methods The clinical data of 48 patients with single osteoporotic vertebral compression fractures treated with kyphotic kyphoplasty in our hospital from July 2011 to May 2013 were retrospectively analyzed. The CPC group consisted of 23 patients, 9 males and 14 females, ranging in age from 61 to 82 years with an average of 69.59 years. PMMA group consisted of 25 males and 11 females with 14 females, ranging in age from 67 to 89 years (mean, 71.23 years). All patients were examined before operation, immediately after operation, 3,6,12,24 months after operation. Evaluate the incidences of visual analogue scale (VAS), duration of analgesic use, satisfaction with surgery, compression rate of vertebral body, kyphotic deformity and complications. Results There was no significant difference in age, sex, time between injury and operation after operation in both groups. Postoperative VAS score, painkillers duration of use, surgical satisfaction, vertebral height recovery and kyphosis had no significant difference between the two groups (P> 0.05), were significantly improved compared with preoperative. There was no significant difference between the two groups in secondary fracture and bone cement leakage (P> 0.05). At 3 months after operation and at the final follow-up, the compression rates of vertebral body in CPC group were (23.26 ± 10.08)% and (23.39 ± 11.23)%, respectively, which were significantly lower than those in the CPC group (17.22 ± 14.19)% There was statistical significance (P <0.05). Conclusion CPC is as safe and effective as PMMA in the treatment of osteoporotic vertebral compression fractures. It can relieve the pain and improve the activity, but some of them will be lost after the CPC is recovered.