经皮椎体成形术治疗新鲜骨质疏松性椎体骨折伴不同类型的椎体裂隙OA

Objective To compare the efficacy of percutaneous vertebroplasty(PVP)in treating fresh osteoporotic vertebral fractures with different types of vertebral fissure.Methods The 73 patients with fresh osteoporotic vertebral fractures accompanied by vertebral fissures were divided into group A(fissure adjacent to the upper endplate,47 ca-ses),group B(fissure adjacent to the lower endplate,12 cases),and group C(fissure located in the middle of the vertebral body,14 cases)based on the different positions of the fissures.The bone cement leakage and dispersion,pain VAS,and ODI were compared among the three groups.Results All patients were followed up for 3～10 months.The bone cement leakage occurred in 23 cases of group A(23/47),7 cases of group B(7/12),and 6 cases of group C(6/14).The leakage rate of group B was higher than that in group A and group C(P＜0.05).The bone ce-ment dispersion was mainly type 3 in groups A and B,and type 1 in group C.The pain VAS:At the postoperation and the last follow-up,three groups were all improved,compared with those before the operation(P＜0.05);at the last fol-low-up,there was no statistical difference among the three groups(P＞0.05).The ODI of the three groups after the operation was all improved,compared with that before the operation(P＜0.05);ODI:At the postoperation,three groups were improved than the preoperation(P＜0.05),and group A,C were both lower than that of group B(P＜0.05).Conclusions There is different efficacy for PVP in treating fresh osteoporotic vertebral fractures with differ-ent types of vertebral fissure.The bone cement dispersion is relatively better in the vertebral fissures adjacent to the upper or lower endplate,and the bone cement leakage rate is higher in the vertebral fissures adjacent to the lower endplate.The stress is relatively more concentrated,and the overall efficacy is relatively worse.