局解手术学杂志2024，Vol.33Issue(7)：587-591,5.DOI:10.11659/jjssx.05E023146
骨质疏松性椎体压缩性骨折患者球囊椎体后凸成形术后骨水泥渗漏与球囊扩张压力的关系
Relationship between bone cement leakage after balloon kyphoplasty and balloon expansion pressure in patients with osteoporotic vertebral compression fracture
摘要
Abstract
Objective To analyze the relationship between bone cement leakage after balloon kyphoplasty(BKP)and balloon expansion pressure(BEP)in patients with osteoporotic vertebral compression fracture(OVCF).Methods The clinical data of 116 elderly patients with OVCF who received BKP in our hospital were retrospectively analyzed.All patients underwent X-ray examination and CT enhanced scan before surgery and 72 hours after surgery to evaluate the efficacy and the occurrence of bone cement leakage.According to whether the bone cement leaked or not,he patients were divided into the bone cement leakage group and the non-bone cement leakage group.The pain was assessed by visual analogue scale(VAS)score,and the disturbance of daily living was assessed by Barthel index score.The area under the curve(AUC)and optimal cut-off value of BEP and bone cement volume to predict bone cement leakage were analyzed using receiver operating characteristic(ROC)curve.The risk factors of bone cement leakage was analyzed by multivariate Logistic regression analysis.Results There were 82 cases of mono-segment operation,27 cases of double-segment operation,and 7 cases of three-segment operation,involving 157 vertebrae.The anterior vertebral height and posterior vertebral height,the local kyphosis Cobb angle at the sagittal plane,and thoracolumbar kyphosis angle after surgery were significantly corrected,and the VAS score and Barthel index score were better than those before surgery(P<0.05).The bone cement leakage after surgery occurred in 24 patients,including 1 case with pulmonary cement embolism.The intraoperative BEP and volume of bone cement in the bone cement leakage group were significantly higher than those in the non-bone cement leakage group(P<0.05).ROC curve analysis showed that both the intraoperative BEP(AUC=0.756)and bone cement volume(AUC=0.661)could predict cement leakage,with the optimal cut-off value of 135 psi and 6.08 mL,respectively.Multivariate Logistic regression analysis showed that BEP≥135 psi was a risk factor for bone cement leakage(OR=1.038,95%CI:1.018 to 1.058,P<0.001).Conclusion BKP is a safe and effective treatment for OVCF in elderly patients,higher BEP is a risk factor for cement leakage,and patients with BEP≥135 psi are at higher risk of bone cement leakage.关键词
骨质疏松性椎体压缩性骨折/球囊椎体后凸成形术/骨水泥渗漏/球囊扩张压力Key words
osteoporotic vertebral compression fracture/balloon kyphoplasty/bone cement leakage/balloon expansion pressure分类
医药卫生引用本文复制引用
陈俊,缪逸鸣,蒋晓伟,陆苇,王强..骨质疏松性椎体压缩性骨折患者球囊椎体后凸成形术后骨水泥渗漏与球囊扩张压力的关系[J].局解手术学杂志,2024,33(7):587-591,5.基金项目
江苏省2019年度苏州市临床重点病种诊疗技术专项项目(LCZX201923) （LCZX201923）
江苏省2019年常熟市卫生健康委员会科技计划项目(CSWS201928) （CSWS201928）
