| Objective:A retrospective case cohort study was conducted to investigate the effect of cement leakage in percutaneous vertebroplasty(PVP)on postoperative pain,kyphosis,disc height and fracture rate of adjacent vertebrae in osteoporotic vertebral fracture(OVCF).Methods:To retrospectively analyze the clinical data of PVP treatment of OVCF patients with single vertebral fractures and upper endplate fractures from May 2018 to August 2019 in the Hospital of Xi'an Hong-hui Hospital.Patients were selected according to the inclusion and exclusion criteria.During follow-up,190 patients(190vertebrae)met the inclusion criteria.According to whether the bone cement was leaking during the operation,it was divided into 2 groups,group A was the non-cement cement leakage group,a total of 110 patients,and group B was the intraoperative cement cement leakage group,there were 80 patients.Collect general patient information,such as age,gender,time from injury to operation,bone density,amount of bone cement injected,follow-up time,and injured vertebral segment,and record the patient's pain before,after,3 months,and last follow-up Visual Analogue Scale(VAS)and Oswestry Dability Index(ODI).X-ray examination of the spine was performed at each follow-up,and the X-ray film was used to measure the Cobb angle of the injured kyphosis and the height of the adjacent intervertebral disc.During the follow-up process,if the patient was revisited due to a compression fracture of the adjacent vertebral body,it was recorded as a fracture of the adjacent vertebral body.Compare the VAS,ODI,kyphotic Cobb angle and height of adjacent intervertebral discs in group A and group B before operation,after operation,3 months after operation and at the last follow-up,and compare the adjacent vertebral body compression fractures rate in group A and group B.Results:A total of 174 patients completed the follow-up study.There were 102patients in group A and 72 patients in group B.There was no statistical difference between the general data of patients in group A and group B before surgery(P>0.05).Among the 174 patients,48??were male and 126 were female.The age was 68.45±3.08 years old.The time from injury to operation was 3.20±1.84 days.The injured vertebral segment:thoracic segment(chest 4-chest 10)44 cases.Chest 11-waist 2)100 cases,waist section(waist 3-waist 5)30 cases.All patients were osteoporosis,T value of bone density was 3.00±0.43,the amount of cement injected into injured vertebrae was 4.95±0.93ml,and the follow-up time was 12.14±1.69 months.There was no statistical difference between the general data of patients in group A and group B before operation(P>0.05).The VAS score and ODI index of patients in groups A and B were significantly lower than that before surgery(P<0.05).At 3 months after surgery,the VAS score and ODI index of the two groups of patients were less than that after surgery,and they recovered somewhat after surgery(P<0.05).At the last follow-up,the VAS score and ODI index of the two groups were lower than those before and after the operation(P?0.05).The VAS score and ODI index of the group B increased compared with those after 3 months(P?0.05).The VAS score of the group A Compared with 3months after operation,there was no change(P>0.05),and the ODI index increased compared with 3 months after operation(P?0.05),but the VAS and ODI scores of group B were significantly higher than those of group A(P?0.05).There was no significant difference in the height of the intervertebral disc between group A and group B at 3 months after operation(P>0.05).During the last follow-up,the height of the intervertebral disc in both groups was lower than that before and 3 months after operation(P?0.05),but the disc height in group B was significantly lower than that in group A(P?0.05).There were no statistical differences between the two groups of patients in group A and group B before operation,after operation and 3 months after operation(P>0.05).The Cobb angle of injured vertebrae in group B at the last follow-up was different from that after operation and 3 months after operation Increased(P?0.05),the Cobb angle of injured vertebrae in group A was not significantly different from that after operation and 3 months after operation(P>0.05),and there was a significant difference between the two groups(P?0.05).The fracture rate of adjacent vertebral body in group A was 7.84%(8/102),and the fracture rate of adjacent vertebral body in group B was 18.06%(12/72).The fracture rate of adjacent vertebral body between group A and group B was significant differences.(?~2=4.15,P=0.04).Conclusion:The bone cement leaked into the intervertebral space through the fracture of the upper end plate has no obvious effect on the relief of postoperative PVP pain,but in the long-term prognosis,it may aggravate the patient's low back pain,reduce the height of the intervertebral disc,and aggravate the kyphosis deformity.And increase the risk of fractures of adjacent vertebral bodies. |
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