The efficacy and dispersion analysis of high viscosity cement in the treatment of osteoporotic vertebral compression fractures with different degrees of osteoporosis / 中国基层医药

ABSTRACT

Objective To observe the efficacy and difference of dispersion of osteoporotic vertebral fractures with high-viscosity cement in the treatment of vertebral compression fractures with different degrees of osteoporosis.Methods From October 2013 to October 2016,a total of 65 patients with clinically diagnosed thoracolumbar osteoporotic fractures in Beijing Geriatrics Hospital were selected,and they were divided into three groups according to Genant semiquantitative method:24cases of] degree group (vertebral compression ≤ 25％),23cases of Ⅱ degree group(vertebral compression of ＞ 25％-40％),18 cases of Ⅲ degree group(vertebral compression ＞ 40％).All patients underwent vertebroplasty and received high viscosity bone cement.CT scan was performed after operation,then the volume of vertebral bone cement dispersion and diffusion coefficient were calculated,the differences among different groups were compared.The visual analogue scale(VAS) of all patients were recorded before operation,1 day after operation and 6 months after operation.The differences of preoperative and postoperative VAS scores were compared to evaluate the therapeutic effect of high viscosity cement on PVP.Results There were no statistically significant differences among the three groups in the time of single vertebral body operation and the amount of cement injected(all P ＞0.05).However,the volume and the diffusion coefficient of the cement in the Ⅲ degree group [(8.25 ± 1.38)mL and (2.15 ± 0.21)] were significantly different from those in the Ⅱ degree group[(9.32 ±1.85) mL and (2.42 ± 0.27)] (t =2.43,3.51,all P ＜ 0.05) and the Ⅰ degree group [(9.38 ± 1.92) mL and (2.44 ± 0.23)] (t =2.12,2.29,all P ＜ 0.05).There were no statistically significant differences in the volume and the dispersion coefficient of cement between the Ⅰ degree group and Ⅱ degree group(t =0.11,0.29,all P ＞0.05).The postoperative VAS score decreased significantly,and the differences were statistically significant among preoperation,postoperative 1 day and postoperative 6 months (t =28.21,27.01,all P ＜ 0.01).Conclusion The VAS score of patients with OVCF decreases significantly after PVP treatment with high viscosity cement.The pain symptoms of patients with OVCF are significantly relieved in both short-term and long-term,and PVP with high viscosity cement has a very low incidence rate of bone cement leakage.The different degree of preoperative vertebral compression doesn't affect the amount of bone cement injection and operation time,but partly impact the dispersion of high viscosity cement,shown as the dispersion volume and diffusion coefficient of bone cement can decline with the increase of the degree of vertebral compression,especially for heavily compressed vertebral fractures,the dispersion of bone cement is clearly diminished.