Effect of bone cement distribution near the fracture line after percutaneous vertebroplasty on patients with osteoporotic vertebral compression fractures / 中国医师进修杂志

ABSTRACT

Objective To investigate the effect of bone cement distribution near fracture line after percutaneous vertebroplasty (PVP) on patients with osteoporotic vertebral compression fractures (OVCF). Methods One hundred and twenty OVCF patients who had underwent PVP from September 2015 to August 2017 were selected. The range of fracture line was determined by magnetic resonance lipid suppressor sequence imaging before operation, and the three-dimensional modeling was carried out by computer aided design software. Three dimensional imaging of CT bone cement was performed after PVP. The patients were divided into 2 groups according to the bone cement distribution near fracture line. The bone cement distribution near fracture line area was not good in 52 cases (group A), and the bone cement distribution near fracture line was good in 68 cases (group B). The pain visual analogue score (VAS) and the Oswestry dysfunction index (ODI) were measured before operation, second day after operation and 3 months after operation. Results All the patients completed the operation successfully, and the postoperative pain was significantly relieved. In group A, there were 3 cases of with postoperative bone cement leakage, and 4 cases in group B. There were no obvious clinical symptoms, no serious complications such as nerve injury and infection. There was no significant difference in the amount of bone cement between group A and group B: (4.08 ± 0.74) ml vs. (4.03 ± 1.03) ml, P＞0.05. There were no significant differences in VAS and ODI before operation between 2 groups (P>0.05). The VAS and ODI second day and 3 months after operation were significantly lower than those before operation in 2 groups, VAS: (4.54 ± 0.81) and (1.46 ± 0.51) scores vs. (7.38 ± 0.94) scores, (2.68 ± 0.88) and (1.18 ± 0.58) scores vs. (7.21 ± 1.12) scores; ODI: (70.23 ± 2.70) and (19.42 ± 2.21) scores vs. (90.46 ± 1.79) scores, (48.85 ± 2.23) and (18.85 ± 1.84) scores vs. (90.50 ± 2.02) scores, and there were statistical differences (P＜0.05). The VAS and ODI second day after operation in group B were significantly lower than those in group A, and there were statistical differences (P＜0.01). There were no significant differences in VAS and ODI 3 months after operation between 2 groups (P>0.05). Conclusions PVP can obviously relieve the pain of OVCF patients. The bone cement is well distributed near the fracture line, and the early effect is obvious.