Percutaneous Curved Vertebroplasty For Osteoporotic Vertebral Compression Fractures And Risk Factors For Bone Cement Leakage

Objective(1)To investigate the clinical efficacy of percutaneous curved vertebroplasty in the treatment of osteoporotic vertebral compression fractures.(2)To analyze the risk factors PCVP bone cement leakage after operation.Methods(1)Retrospective analysis of the clinical data of 179 patients undergoing vertebral augmentation surgery from January 2016～ January 2020 in our hospital,unilateral PVP group(n=56),bilateral PVP group(58),PCVP group(65).Comparison of operative time,amount of bone cement injected,distribution of bone cement,visual analogue scale in three groups VAS score and ODI score(preoperative,postoperative 3 days,postoperative 1 month),bone cement leakage and postoperative re-fracture.(2)Retrospective analysis of the clinical data of 101 OVCF patients undergoing PCVP surgery from January 2016 to October 2020,according to the occurrence of cement leakage,it was divided into leakage group and non-leakage group.The data of age,sex,position of injured vertebral body,degree of compression of vertebral body,choice of puncture side,integrity of bone mass and amount of cement were recorded,Then the statistical significance of the observation indicators were multi-factor Logistic regression analysis.Results(1)With regard to the duration of the operation,The time of unilateral PVP group(34.45±4.31)min was comparable to that of PCVP group(35.92±6.45)min(p>0.05),The time was shorter than that of bilateral PVP group(43.97±5.80)min(p <0.05),the difference was statistically significant;In terms of the amount of bone cement,bilateral PVP group(6.28±1.18)ml>PCVP group(4.69±1.10)ml>PCVP unilateral(1.05)(p<0.05),the difference was statistically significant;Distribution of bone cement,Similar between bilateral PVP group and PCVP group(p >0.05),the difference between unilateral PVP group and other two groups(p <0.05),the difference was statistically significant;The VAS score and ODI score of 3 days and 1 month after operation were significantly improved,and showed a downward trend(p <0.05),the difference was statistically significant;In the case of cement leakage,the leakage of bilateral PVP group and PCVP group was similar(p >0.05),the leakage was heavier than that of unilateral PVP group(p <0.05),the difference was statistically significant;In the case of recurrent fractures,there was no significant difference between unilateral PVP group,bilateral PVP group and PCVP group(p >0.05).(2)Results Of the 101 patients,Bone cement leakage in 30 cases,the leakage rate is29.70.Single factor analysis shows,Between the two groups,there were significant differences in the degree of vertebral compression,the choice of puncture side,the integrity of bone edema and the amount of bone cement(p <0.05),the difference was statistically significant,all of them PCVP the risk factors of bone cement leakage after operation;Multivariate analysis showed,the greater the degree of compression of the vertebral body,the bone cement dosage greater than 4.5 ml,the damage of the bone cortex and through the light side puncture are all risk factors for PCVP postoperative bone cement leakage.(p <0.05)Conclusion(1)PCVP operation can effectively relieve pain,save operation time,bone cement is well distributed and no increase in postoperative re-fracture.(2)The greater the degree of compression of the vertebral body,the bone cement dosage greater than 4.5 ml,the damage of the bone cortex and through the light side puncture are all risk factors for PCVP postoperative bone cement leakage.