Study On The Distribution Area Of Bone Cement And The Degree Of Pain Relief In Vertebral Body After PVP

Objective:To investigate the effect of bone cement distribution areas on postoperative pain relief degree after PVP.Methods:Using a retrospective study method to make a statistical analysis about 108 patients with single segment osteoporotic thoracolumbar vertebral fractures who performed PVP surgery of the Second Hospital of Shanxi Medical University department of orthopaedics from December 2015 to December 2017.The average age range from 65 to 86 years old.During the operation,the patient took a prone position,and the skin was partially anesthetized and then injected PMMA into the vertebra.According to the CT scan of thoracolumbar vertebra,the distribution of bone cement was divided into three planes: transverse plane,sagittal plane and coronal plane.In the transverse plane,the vertebral body is divided into four parts,the bone cement distribution has 6 different shape;in the sagittal plane,the vertebral body was divided into three sections,and the distribution of bone cement in the sagittal plane of the vertebral body was divided into 6 types;in the coronal plane,the vertebral body was divided into two parts from the posterior median line of the vertebral body,and the distribution of bone cement in the coronal plane was divided into three types.The visual analogue scores were measured of preoperation,postoperation and 3,6,12 months after surgery based on the bone cement distribution of different areas in different plane,and then analysis VAS and variance for each group before and after operation,and postoperative complications were observed too.And according to the result,we can know the best distribution area of bone cement.Results:There was a statistical difference between VAS score and preoperative comparison in all patients.After 3 months,6 months,12 months,VAS score is performed.In the transverse plane,there is no statistical difference between Ⅰand Ⅱgroup(P = 0.835),and no statistical difference between Ⅲ-Ⅵ groups(P > 0.05)are observed.But when compared Ⅲ-Ⅵ groups with Ⅰ,Ⅱ group,we found that there was statistically difference(P < 0.05).In the sagittal plane,there were statistically significant differences between the group(1)(2)(3)and the group(4)(5)(6)(P < 0.05).However,there was no statistical difference in the groups(1)(2)(3)and the groups(4)(5)(6)(P>0.05).In coronal plane,the VAS scores were statistically significant between(P = 0.000)α(bone cement distribution in the side)andβgroup,α(bone cement distribution in midline bilateral but asymmetric)and γgroup(bone cement distribution in the middle but distribution is symmetrical on both sides).There was no statistical difference between the group βand the group γ(P=0.557).Conclusion:There is a significant correlation between the distribution area of bone cement in PVP and the degree of postoperative pain relief.The bone cement should be widely distributed in the transverse plane,but it should be careful to prevent the leakage of bone cement.Bone cement in sagittal plane should be as close as possible to the bilateral endplate.The cement should be distributed on both sides of the middle line.This can have good clinical curative effect.