实用医学杂志 ›› 2022, Vol. 38 ›› Issue (22): 2828-2837.doi: 10.3969/j.issn.1006⁃5725.2022.22.012

• 临床研究 • 上一篇    下一篇

浸骨水泥明胶海绵预填注联合骨水泥分次注射对骨质疏松性胸腰椎骨折经皮穿刺椎体后凸成形术术中骨水泥渗漏的影响 

付斌 董毅 丁惠强    

  1. 宁夏医科大学总医院脊柱骨科(银川 750004)

  • 出版日期:2022-11-25 发布日期:2022-11-25
  • 通讯作者: 丁惠强 E⁃mail:shequ9779@163.com ​
  • 基金资助:
    宁夏自然科学基金项目(编号:2019AAC03207)

Effect of bone cement impregnated gelatin sponge pre filling combined with bone cement injection in differ⁃ ent times on bone cement leakage during PKP in osteoporotic thoracolumbar fractures

FU Bin,DONG Yi,DING Huiqiang.   

  1. Department of Spine Orthopedics,General Hospital of Ningxia Medical University,Yinchuan 750004,China

  • Online:2022-11-25 Published:2022-11-25
  • Contact: DING Huigao E⁃mail:shequ9779@163.com

摘要:

目的 探讨浸骨水泥明胶海绵预填注联合骨水泥分次注射对骨质疏松性胸腰椎骨折经皮 穿刺椎体后凸成形术(percutaneous kyphoplasty,PKP)术中骨水泥渗漏的影响。方法 选取宁夏医科大学 总医院 2019 4 月至 2020 8 月收治的 88 例骨质疏松性胸腰椎骨折患者。采用随机数字表分为 2 组,对照组术中采用明胶海绵填塞联合骨水泥分次注射,观察组采用浸骨水泥明胶海绵预填注联合骨水泥分次注射。结果 观察组明胶海绵用量、骨水泥注入量均少于对照组(P < 0.05);2组骨水泥弥散Ⅰ、Ⅱ度占比、 术后 3 个月腰椎功能障碍指数(ODI)评分差异均无统计学意义(P > 0.05);观察组术中骨水泥渗漏发生率 低于对照组(P < 0.05);2 组术后即刻椎体后凸角均小于术前(P < 0.05),且观察组小于对照组(P < 0.05), 2组术后即刻伤椎前缘高度均高于术前(P < 0.05),且观察组高于对照组(P < 0.05);2组均无不良反应;2 邻近椎体骨折发生率比较差异无统计学意义(P > 0.05)。结论 浸骨水泥明胶海绵预填注联合骨水泥分 次注射在骨质疏松性胸腰椎骨折 PKP 术中应用可减少明胶海绵用量、骨水泥注入量,降低骨水泥渗漏发 生率,且可促进伤椎解剖结构恢复。

关键词:

骨水泥, 明胶海绵, 骨质疏松症, 胸腰椎骨折, 经皮穿刺椎体后凸成形术, 骨水 泥渗漏

Abstract:

Objective To investigate the effect of bone cement impregnated gelatin sponge pre filling com⁃ bined with bone cement injection on bone cement leakage during percutaneous kyphoplasty(PKP)for osteoporotic thoracolumbar fractures. Methods 88 patients with osteoporotic thoracolumbar fractures treated in General Hospital of Ningxia Medical University from April 2019 to August 2020 were selected as the subjects,and all of them were planned to undergo PKP treatment. They were randomly divided into two groups. The control group was treated with gelatin sponge packing and bone cement injection,while the study group was treated with bone cement impregnat⁃ ed gelatin sponge pre filling combined with bone cement injection. Results The amount of gelatin sponge and the amount of bone cement injected in the study group were less than those in the control group(P < 0.05). There was no significant difference in the proportion of Ⅰ and Ⅱ degree of bone cement dispersion,lumbar dysfunction index (ODI)scores at 3 months after operation between the study group and the control group(P > 0.05). The incidence of bone cement leakage in the study group was lower than that in the control group(P < 0.05). The kyphosis angle of the two groups was smaller than that before operation(P < 0.05),and the study group was smaller(P < 0.05). The anterior height of injured vertebrae in both groups was higher than that before operation(P < 0.05),and the study group was higher(P < 0.05). There were no adverse reactions in both groups. There was no significant differ⁃ ence in the incidence of adjacent vertebral fractures between the two groups(P > 0.05). Conclusion The applica⁃ tion of bone cement impregnated gelatin sponge pre filling combined with bone cement injection in PKP for osteopo⁃rotic thoracolumbar fractures can reduce the amount of gelatin sponge and bone cement injection,reduce the inci⁃ dence of bone cement leakage and promote the recovery of anatomical structure of injured vertebrae.

Key words:

bone cement, gelatin sponge, osteoporosis, thoracolumbar fractures, percutaneous kyphoplasty, bone cement leakage