摘要
背景:骨水泥渗漏是经皮椎体后凸成形术(PKP)后最常见的并发症之一,有研究初步表明骨水泥椎间隙渗漏会加速渗漏椎间盘的退变。目的:探讨PKP后骨水泥椎间隙渗漏与渗漏椎间盘高度的相关性。方法:回顾性分析2016年1月至2018年12月因骨质疏松性椎体压缩性骨折(OVCF)行PKP治疗的患者212例。根据是否发生骨水泥椎间隙渗漏分为渗漏组(28例)及未渗漏组(184例)。测量并计算术前、术后1 d与术后12个月两组患者平均椎间盘高度、椎间盘高度系数及椎间盘腹侧高度,同时测量并计算术后1 d、术后12个月渗透组患者渗漏到椎间隙的骨水泥高度与椎间盘高度的比值(骨水泥渗漏高度/椎间盘高度),分析骨水泥渗漏与椎间盘高度退变的相关性。结果:未渗漏组患者随访时间14.2~20.6个月,平均随访时间为(17.2±3.5)个月;渗透组患者随访时间12.5~22.8个月,平均随访时间为(18.8±4.9)个月。术后12个月未渗漏组患者平均椎间盘高度、椎间盘高度系数及椎间盘腹侧高度均大于渗漏组患者,且差异均有统计学意义(P均<0.05)。渗漏组患者椎间盘高度减少及椎间盘高度减少率均大于未渗漏组患者,且差异均有统计学意义(P均<0.001)。Pearson相关分析结果显示,术后1 d、术后12个月渗漏组患者骨水泥渗漏高度/椎间盘高度与椎间盘高度减少率均呈正相关(r=0.879、0.959,P<0.001)。结论:PKP术后骨水泥椎间隙渗漏会加剧渗漏椎间盘退变进程。此外,渗漏骨水泥高度/椎间盘高度比值越大,椎间盘高度减少率越高。
Background:Bone cement leakage is one of the most common complications after percutaneous kyphoplasty(PKP).Preliminary studies have showed that the leakage of bone cement into the intervertebral space can accelerate the degeneration of leaky discs.Objective:To investigate the correlation between intradiscal cement leakage and cementcontaining intervertebral height after PKP.Methods:A total of 212 patients with osteoporotic vertebral compression fracture(OVCF)treated with PKP from January 2016 to December 2018 were retrospectively analyzed and divided into cement leakage group(28 cases)and non-leakage group(184 cases)according to intraoperative X-ray.The disc height,disc height coefficient and ventral disc height were measured and calculated before operation,on day 1 and 12 months after operation.The ratio of the height of bone cement leakage into the intervertebral space to the height of the intervertebral disc was measured,and the correlation between bone cement leakage and disc height degeneration was analyzed.Results:The mean duration of follow-up was(17.2±3.5)months(range,14.2-20.6 months)in the non-leakage group and(18.8±4.9)months(range,12.5-22.8 months)in the leakage group.The mean disc height,disc height coefficient and ventral disc height in the non-leakage group were significantly higher than those in the leakage group 12 months after surgery(P<0.05).Disc height reduction and rate of disc height reduction in the leakage group were significantly higher than those in the non-leakage group(P<0.001).Pearson correlation analysis showed that there was a positive correlation between the height of bone cement leakage/disc height and the rate of disc height reduction on day 1 and 12 months after operation(r=0.879 and 0.959,P<0.001).Conclusions:Cement intervertebral leakage after PKP exacerbates the degeneration of the disc.In addition,the greater the leaky cement height/disc height ratio,the higher the rate of disc height reduction.
作者
高剑峰
沈文东
张军强
刘亦凡
汤月平
GAO Jianfeng;SHEN Wendong;ZHANG Junqiang;LIU Yifan;TANG Yueping(Department of Orthopaedic,Suzhou Municipal Hospital,Nanjing Medical University,Suzhou 215000,Jiangsu,China)
出处
《中华骨与关节外科杂志》
2021年第3期181-185,190,共6页
Chinese Journal of Bone and Joint Surgery
关键词
经皮椎体后凸成形术
骨质疏松性椎体压缩性骨折
椎间隙渗漏
椎间盘高度
Percutaneous Kyphoplasty
Osteoporotic Vertebral Compression Fracture
Intradiscal Cement Leakage
Intervertebral Height
作者简介
通信作者:汤月平,E-mail:tangspine@163.com
