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[Correlation between the distribution of bone cement and clinical efficacy in the treatment of osteoporotic spinal fractures with percutaneous vertebroplasty]

[Article in Chinese]

Yang J1.

Zhongguo Gu Shang. 2019 Dec 25;32(12):1128-1133. doi: 10.3969/j.issn.1003-0034.2019.12.012.

 

Abstract

OBJECTIVE:

To investigate the effect of bone cement dispersion and distribution on the clinical effect and the degree of pain reduction of percutaneous vertebroplasty(PVP) in the treatment of osteoporosis spinal fracture.

METHODS:

A retrospective analysis was made of 130 cases of osteoporotic spinal fractures admitted from August 2016 to April 2018, of which 114 cases were followed up completely. The VAS score, Oswestry disability index(ODI), kyphosis angle(Cobb angle), anterior column height and complications were analyzed.

RESULTS:

Finally, 114 cases were included. The grade of bone cement dispersion was 42 cases (36.8%) in grade 1, including 14 males and 28 females, with an average age of (73.43 ±7.91) years. There were 36 cases of grade 2(31.6%), including 10 males and 26 females with an average age of (71.22 ±8.06) years, and 36 cases with grade 3 (31.6%), including 9 males and 27 females, with an average age of (74.81 ±6.91) years. There were no significant differences in preoperative general data among the three groups (P>0.05). The VAS, ODI score of grade 1, grade 2 and grade 3 of bone cement dispersion and distribution were significantly lower than those of preoperative follow-up(P<0.05) in the follow-up period of 1, 1, 3 and 6 months after operation(P<0.05). There were no significant differences between the three groups in using single factor ANOVA at the same time point of postoperative follow-up(P>0.05). In terms of bone cement leakage, 15 cases(41.7%) were in grade 2 of diffusion distribution, 23 cases(63.9%) in grade 3 more than 8 cases(19%) in grade 1 of diffusion distribution, exhibiting a significant difference among the three groups (P<0.05). The diffusive distribution in grade 2(7, 19.4%) and grade 3(8, 22.2%) less than that in grade 1(18, 42.9%)(P<0.05). Bone cement dispersion and distribution with grade 2 and 3 level could effectively improve the kyphosis deformity and reduce the loss of anterior column height in the injured vertebrae compared with that with grade 1, showing a statistical difference among the three groups(P<0.05).

CONCLUSIONS:

Bone cement dispersion and distribution with any grades in PVP are effective in relieving pain, and bone cement dispersion and distribution with grade 2 could not only relieve the pain of patients, but also correct the kyphosis angle of the injured vertebrae. The height of the anterior column of the injured vertebrae and the risk of cement leakage and non-operative vertebral body fracture is relatively low.