| Objective: To investigate the effects of different bone cement distributions in the vertebra after percutaneous kyphoplasty(PKP)for osteoporotic vertebral compression fracture(OVCF)on short-term clinical efficacy,and to explore the related factors affecting the distribution of bone cement,so as to provide theoretical basis for clinical treatment.Methods: Seventy patients with OVCF who received treatment in our hospital from November 2018 to December 2021 were selected as research objects.Based on antero-lateral postoperative radiographs,the distribution of bilateral coronal bone cement and sagittal bone cement at the fracture site were evaluated and divided into four groups.Group A: Bone cement distributed uniformly along the fracture line on the sagittal plane and bilaterally on the coronal plane.Group B: Bone cement was uniformly distributed along the fracture line on the sagittal plane but unilateral on the coronal plane.Group C: Bone cement was insufficiently distributed along the fracture line on the sagittal plane but bilaterally distributed on the coronal plane.Group D:Bone cement was underdistributed along fracture lines on the sagittal plane and unilateral on the coronal plane.Statistics was used to compare general clinical data from four groups of patients.At the time of preoperative,3 days after surgery and 6months after surgery,statistical methods were used to compare the visual analogue scale(VAS),the Oswestry disability index(ODI),the Cobb angle of local kyphosis and the anterior edge height of the vertebral body between the four groups.The four groups were compared with postoperative complications.Results: 1.There were no statistically significant differences in gender,age,body weight,bone mineral density,operation time and fracture site among groups A,B,C and D(P > 0.05),but there were significant differences in the course of disease and the amount of bone cement injection among the four groups(P < 0.05).2.VAS pain score,ODI index score,anterior vertebral edge height and local kyphotic Cobb Angle in 4groups were significantly improved 3 days and 6 months after surgery(P < 0.05).3.There was no statistical significance in VAS pain score and ODI index of the four groups 6 months after surgery(P > 0.05),but there was statistical significance in VAS pain score and ODI index score of groups A,B and C 3 days after surgery compared with group D(P < 0.05).4.There was no statistical significance in vertebral anterior margin height and local kyphotic Cobb Angle in the four groups 3 days after surgery,but the vertebral anterior margin height and local kyphotic Cobb Angle in groups A,B and C were significantly improved compared with group D 6 months after surgery(P <0.05).5.Postoperative bone cement leakage in group A,B and C was 2 cases(8.3%),1case(5.6%)and 2 cases(13.3%),respectively,which were significantly lower than 5cases(38.5%)in group D,and the difference was statistically significant(P < 0.05).Postoperative adjacent fractures in group A,B,C and D were 3 cases(12.5%),2 cases(11.1%),1 case(6.7%)and 2 cases(15.4%),respectively,with no statistical significance(P > 0.05).Conclusions: 1.The longer the disease course and the less bone cement injection amount,the insufficient distribution of bone cement on the vertebral fracture line is prone to occur after PKP.2.percutaneous kyphoplasty(PKP)for the treatment of osteoporotic vertebral compression fracture(OVCF)can achieve effective clinical results.3.Patients with bone cement evenly distributed on the sagittal plane along the fracture line and bilaterally distributed on the coronal plane had better effects of early postoperative lumbar pain relief and vertebral function recovery,and lower incidence of bone cement leakage.4.Patients with bone cement uniformly distributed along the fracture line on the sagittal plane and bilaterally distributed on the coronal plane have better advantages in maintaining the height of the anterior vertebral margin and improving the kyphosis after surgery. |
PDF Full Text Request