Individualized Pmma Injection In Treatment Of OVCF And AVN By PVP

Objective: To discuss the PMMA injection and the clinic outcomes by PVP in treatment of OVCF and AVN.Methods: A retrospective study was conducted in 65 patients undergoing percutaneous vertebroplasty(PVP)in Affiliated Zhongshan Hospital of Dalian University between January 2010 and March 2016,including 50 patients with thoracolumbar osteoporotic vertebral compression fractures(OVCF),and 15 patients with nonunion of thoracolumbar compression fractures or delayed union of avascular necrosis of vertebral(AVN).All 65 patients were treated with routine PVP,and the injection amount of bone cement intraoperatively was recorded.Postoperatively,all patients cooperated with anti-osteoporosis therapy and waist protection.Three days,1month,3 months,6 months and 12 months after surgery,improvement in visual analogue scale(VAS)score compared with that before surgery,occurrence of complications and imaging changes were observed;and quality of life(SF-36 scale)1year after surgery was evaluated and compared with that before surgery.Statistical analysis of related data was conducted with t test(SPSS19).Results: In all 65 patients,pain was effectively relieved,without intraspinal or intravascular leakage,and no pulmonary embolism occurred.The amount of bone cement was(5.0 ± 1.5)ml in the OVCF group and(7.0 ± 1.5)ml in the AVN group.Postoperative imaging examination showed good position of bone cement.Statistical analysis revealed that VAS score and SF-36 scale score in the OVCF group and the AVN group after PVP were significantly improved compared with those before the surgery.No adjacent vertebral fractures were detected in both groups after the surgery.Conclusion: PVP is an effective method for treating thoracolumbar OVCF and AVN.The amount of bone cement needed in the AVN group is more than that in the OVCF group.The injection amount of bone cement depend on achieve the individualized principle of that it can not only filling up bone defect space and laying over the fracture line.