Effect Of Distribution And Amount Of Bone Cement On The Curative Effect Of Osteoporotic Vertebral Compression Fracture

[Objective] Observe the effect of percutaneous vertebra vertebroplasty and kyphoplasty in patients with osteoporotic vertebral compression fracture to explore the relationship between bone cement and clinical efficacy,to study the effect of bone cement distribution and bone cement amount whitin vertebral body during vertebroplasty and kyphoplasty by imaging assessment and clinical follow-up.In order to provide theoretical basis and reference for the choice of clinical treatment plan.[Methods] We choosed 103 patients who were diagnosed as osteoporotic vertebral compression fractures in our orthopedic department and went under the percutaneous vertebra vertebroplasty and kyphoplasty from January 2016 to December 2016.All patients were single vertebrae with non-old compression fractures.Before and after operation,VAS scores and imaging data(anterior height,height of middle part and Cobb angle of vertebral body),amount of bone cement,leakage of bone cement,and refracture of spine would be recorded.The patients included were followed up for 1 year after operation.According to unilateral and bilateral puncture,the patients were divided into two groups: unilateral puncture group(group A)and bilateral puncture group(group B).According to the distribution of bone cement in unilateral puncture group,it is divided into two groups: the side distribution of bone cement group(group A1)and the distribution of bone cement over the middle line group(group A2).According to the distribution of bone cement in bilateral puncture group,it was divided into two groups: bone cement independent distribution group(group B1)and the distribution of bone cement over the middle line group(group B2).According to the volume of bone cement(V),we divided into three group,group C:2≤V≤3ml;group D:3<V≤4ml:group E:4<V≤5ml。Statistical methods were used to compare preoperative and postoperative pain scores and iconography data changes,bone cement leakage in each group,spinal refracture.Correlation analysis of bone cement perfusion volume with pain score and imaging data was carried out.To determine whether the distribution and the volume of bone cement affect the effect of surgery,and whether there is a correlation between the volume of cement perfusion and the curative effect.[Results] 1.The VAS scores in each group were significantly improved after operation,and there were significant statistical differences compared with those before operation(P<0.05).The different distribution and volume of bone cement did not affect the improvement of VAS score,there was no correlation between the volume of bone cement and the change of VAS score.2.The height of vertebral body and Cobb angle were significantly improved in all groups,which were significantly different from those before operation(P<0.05).The different distribution and volume of bone cement did not affect the improvement of the height of vertebral body and Cobb angle.3.The leakage rate was similar in unilateral group and bilateral puncture group.The probability of bone cement leakage was higher in the case of bone cement passing through the middle line,and the probability of bone cement leakage was similar with the different amount of bone cement injection.There were 2 cases of adjacent vertebral fracture after operation,all of them were patients whose dose with 5ml.[Conclusions] 1.Vertebral vertebroplasty and kyphoplasty can effectively relieve pain caused by spinal fracture,effectively restore vertebral height and correct local kyphosis.2.The unilateral and bilateral puncture approaches,distribution of bone cement had no effect on pain relief,vertebral height recovery and kyphosis correction.3.Increasing the dosage of bone cement did not increase the degree of pain relief,there was no difference in height recovery and orthopedic effect of injured vertebrae.4.Cases with good dispersion of bone cement are more likely to leak.