Application Of CPC And PMMA Composite Bone Cement In The Treatment Of Osteoporotic Vertebral Fractures

Objective:In this paper,we investigated the preliminary clinical application of calcium phosphate cement(CPC)blended with polymethylmethacryla te(PMMA)cement to form composite bone cement,and analyzed the clinical efficacy of CPC blended with PMMA cement as filling materia l for percutaneous kyphoplasty(PKP)to treat osteoporotic vertebral co mpression fracture(OVCF).Methods:In a retrospective analysis of 44 patients who were diagnosed wit h OVCF by history,examination and auxiliary examination and who u nderwent PKP surgery at the Department of orthopedic surgery,Cheng de Central Hospital between May 2015 and may 2020,the patients we re divided into two groups according to the different surgical filling m aterials,including 21 patients in the composite bone water cement group and 23 patients in the composite bone cement group with CPC and PMMA in the surgical filling materials The filling material was PMM A.The basic preoperative data of the two groups were collected,the pe rioperative observation indexes were compared,and the visual analog s cale(VAS)scores of pain,Oswestry functional disability index(ODI i ndex),anterior to posterior margin height ratio of injured vertebrae,and the Cobb angle of kyphosis were compared before and after surgery between the two groups Whether there were differences in indicators,a nd analyzed whether the differences were statistically significant.Results:All cases had satisfactory follow-up with a mean(13.6±1.2)mon ths of follow-up ranging from 12-15 months.There were no differences in the basic data between the two groups(P>0.05).The operation time of the composite bone cement group was longer than that of conventional bone cement group(P<0.05),and there were no differences in the amount of bone cement used,surgical bleeding,intraoperative fluoroscopy times,and hospital stay between the two groups(P>0.05).Repeated measures analysis of variance the VAS score,ODI index,the height ratio of the anterior and posterior margins of the injured vertebrae,and the Cobb angle of kyphosis were analyzed in two groups: there was no difference between the two groups(F=0.019,F=0.103,F=1.609,F=0.462,P>0.05),and there were differences at different times(F=2952.403,F=33794.159,F=118.144,F=235.030,P<0.05),in which the pain VAS score and ODI index gradually decreased with increasing time(P<0.05).The height ratio of the anterior to posterior margin of the injured spine and the Cobb angle of kyphosis recovered significantly after surgery compared with before surgery(P<0.05),but there was no difference between 1 day after surgery and the last follow-up(P>0.05).There were2 cases of cement leakage and 1 case of clinical vertebral fracture in the postoperative composite cement group;3 cases of cement leakage and 3 cases of clinical vertebral fracture in the traditional cement gro up,and the number of complications of traditional cement was small,but there was no significant difference between the two groups(P>0.05).Conclusion:The treatment of OVCF with CPC and PMMA composite cement PKP can significantly relieve patients’ pain symptoms,improve spinal d ysfunction,restore vertebral morphology,and can achieve a clinical effect comparable to that of conventional cement PMMA,but there is no evidence that CPC and PMMA composite cement can reduce postoper ative complications.