Study On The Difference And Effect Of Bone Cement Filling Rate With Different Viscosity In Percutaneous Vertebroplasty

Object:To analyze the different cement filling rates,leakage,and clinical efficacy of high viscosity bone cement and ordinary viscosity bone cement after percutaneous vertebroplasty(PVP)in the treatment of osteoporotic vertebral compression fracture(OVCF).The clinical efficacy of different cement filling rates and the correlation between different filling rates and leakage were compared.Methods:A retrospective analysis was performed on 49 patients who underwent PVP for treatment of OVCF in the Spinal Surgery Department of the Third Bethune Hospital of Jilin University from March 2019 to November 2020.The patients were divided into high viscosity bone cement group(20 cases with 20 vertebrae)and ordinary viscosity bone cement group(29 cases with 29 vertebrae)according to the different implantable filling materials used in vertebroplasty after diagnosis.Ordinary viscosity bone cement is PMMA(Polymethyl Methacrylate,PMMA)bone cement,which is a product from Heraeus Medical Gmb H.Confidence High Viscosity Spinal Cement is a De Puy Spine Inc product.Depending on the results of postoperative computed tomography,(CT),the postoperative vertebral volume(narrow definition of vertebral body,that is,excluding the vertebral arch,lamina,transverse process and spinous process)and the volume of bone cement filled during operation were both calculated by Mimics Research17.0medical image processing software.The filling rate,filling diffusion mode,leakage,vertebral height,Cobb angle,and visual analogue score(VAS)of patients before and after operation in the high viscosity bone cement group and ordinary viscosity bone cement group were analyzed and compared.The bone cement filling rate was calculated as the volume of bone cement filled operatively/the volume of the injured vertebra100%.The leakage rate of bone cement was calculated by the formula:bone cement leakage rate = the number of vertebrae with bone cement leakage postoperatively/the total number of the operated vertebra 100%.Results:The main results were as follows:(1)there was no significant difference in the distribution of basic data(sex,age and segment of vertebral body treated by operation)(P > 0.05).(2)The cement filling rate of postoperative injured vertebral in the high viscosity bone cement group was higher than that in the ordinary viscosity bone cement group(P <0.05).There was a statistically significant difference in the bone cement filling rate of the patients with bone cement leakage.(3)The cement leakage rate of postoperative injured vertebral in the high viscosity bone cement group was lower than that in the ordinary viscosity bone cement group(P < 0.05).(4)There was no significant difference in visual analogue score after operation.(5)The Cobb angle was significantly improved postoperatively in the high viscosity bone cement group.The Cobb angle was no significant difference in the ordinary viscosity bone cement group before and after the operation.No significant difference in vertebral compression ratio was observed between the two groups before and after the operation.(6)There was a statistically significant difference between the bone cement filling rate of all leaking patients and non-leaking patients.(7)As a related factor in preventing bone cement leakage,the best value of bone cement filling rate is 36.64%.Conclusions:The bone cement filling rate of the injured vertebrae after PVP in the high viscosity bone cement group was significantly higher than that in the ordinary viscosity bone cement group.The leakage rate of bone cement after PVP in the high viscosity bone cement group was significantly lower than that in the ordinary viscosity bone cement group.High viscosity bone cement has a certain positive significance for the recovery of Cobb angle of vertebral body postoperatively.Additionally,the filling rate of bone cement can be used as a diagnostic factor to prevent bone cement leakage,and the best filling rate is 36.64%.Moderate bone cement filling rate and low bone cement leakage rate have a better efficacy on the recovery of vertebrae after PVP and play a positive role in the prevention of complications related to bone cement leakage,vertebral re-fracture,and adjacent vertebral fracture.Therefore,it is suggested that in the absence of obvious contraindications,vertebroplasty can be performed with high viscosity bone cement.