The efficacy and safety of PKP with different doses of high-viscosity bone cement in the treatment of osteoporotic lumbar vertebral fracture

doi:10.3877/cma.j.issn.2096-0263.2022.01.004

Abstract

Abstract:

Objective

To discuss the efficacy and safety of percutaneous kyphoplasty (PKP) with different doses of high-viscosity bone cement in the treatment of osteoporotic lumbar vertebral fracture (OLVF).

Methods

The 150 patients with OLVF in our hospital from September 2016 to September 2018 were selected, there were 84 males and 66 females, aged (60±8) years. They were divided into high-dose group, medium-dose group and low-dose group according to the random number table, 50 cases in each group. The injections of high-viscosity bone cement were 5.0-7.0 ml, 3-4.9 ml and <3.0 ml in high-dose group, medium-dose group and low-dose group respectively, and the efficacy and safety of the three groups were compared.

Results

The 150 patients were followed up satisfactorily for (19±7) months. There was no significant difference in operation time and intraoperative bleeding between high-dose group, medium-dose group and low-dose group (P>0.05). The anterior height of vertebral body in high-dose group and medium-dose group [(27.3±3.1)mm, (26.0±2.9)mm and (26.9±3.0)mm, (25.7±2.8)mm] was significantly higher than that in low-dose group [(23.8±2.8)mm, (21.3±2.5)mm] at 3 and 6 months after operation, the Cobb angle, pain visual analogue score (VAS) and Oswestry dysfunction index (ODI) scores in high-dose group and medium-dose group [(40.2±4.7)°, (41.5±4.8)°, (2.6±0.4) scores, (1.6±0.3) scores, (25.8±3.5) scores, (26.9±3.5) scores and (40.9±4.8)°, (42.1±4.8)°, (2.6±0.4)scores, (1.6±0.3) scores, (26.2±3.5) scores, (27.2±3.7) scores] were significantly lower than those in low-dose group [(46.3±5.3)°, (47.8±5.6)°, (3.3±0.4)scores, (2.3±0.4) scores, (33.3±4.1) scores, (34.3±4.2) scores] at 3 and 6 months after operation, the difference was statistically significant (F=25.371, 18.914, 29.334, 22.457, 34.276, 30.217, 29.364, 20.071, all P<0.001). The leakage rate of bone cement in high-dose group (28.00%) was significantly higher than that in medium-dose group and low-dose group (8.00% and 4.00%), the difference was statistically significant (χ²=10.241, P=0.005).

Conclusions

There are some differences in the efficacy and safety of different doses of high-viscosity bone cement in the treatment of OLVF during PKP, and the middle dosage (3-4.9 ml) of high-viscosity bone cement can achieve good efficacy and safety, it's worth for further clinical promotion.

Key words: Percutaneous kyphoplasty, Doses, High-viscosity bone cement, Osteoporotic lumbar vertebral fractures, Safety

Jun Liu, Zhenlin Fang. The efficacy and safety of PKP with different doses of high-viscosity bone cement in the treatment of osteoporotic lumbar vertebral fracture[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2022, 08(01): 18-23.

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References 22

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组别	例数	性别（例，男/女）	骨折椎体（L_1/2/3/4）	年龄（岁， ±s）	体质量指数（kg/m²， ±s）	骨质疏松病程（年， ±s）	椎体塌陷度（%， ±s）
低量组	50	28/22	16/14/12/8	60±8	23.6±2.6	6.5±0.7	48±5
中量组	50	26/24	18/12/10/6	59±8	23.5±2.6	6.4±0.8	49±5
高量组	50	30/20	14/16/10/10	60±8	23.8±2.6	6.6±0.7	49±6
χ²/F值		0.934	1.071	0.724	0.824	0.782	0.992
P值		0.304	0.244	0.426	0.371	0.403	0.251

组别	例数	性别（例，男/女）	骨折椎体（L_1/2/3/4）	年龄（岁， ±s）	体质量指数（kg/m²， ±s）	骨质疏松病程（年， ±s）	椎体塌陷度（%， ±s）
低量组	50	28/22	16/14/12/8	60±8	23.6±2.6	6.5±0.7	48±5
中量组	50	26/24	18/12/10/6	59±8	23.5±2.6	6.4±0.8	49±5
高量组	50	30/20	14/16/10/10	60±8	23.8±2.6	6.6±0.7	49±6
χ²/F值		0.934	1.071	0.724	0.824	0.782	0.992
P值		0.304	0.244	0.426	0.371	0.403	0.251

组别	例数	手术时间（min）	术中出血量（ml）	骨水泥注入量（ml）
低量组	50	30±6	7.2±1.4	2.2±0.5
中量组	50	31±6	7.5±1.4	3.7±0.6
高量组	50	32±6	7.6±1.4	6.1±0.6
F值		1.367	1.036	37.261
P值		0.182	0.276	<0.001

组别	例数	手术时间（min）	术中出血量（ml）	骨水泥注入量（ml）
低量组	50	30±6	7.2±1.4	2.2±0.5
中量组	50	31±6	7.5±1.4	3.7±0.6
高量组	50	32±6	7.6±1.4	6.1±0.6
F值		1.367	1.036	37.261
P值		0.182	0.276	<0.001

组别	例数	术前	术后3个月	术后6个月
低量组	50	15.2±1.9	23.8±2.8	21.3±2.5
中量组	50	15.3±1.8	26.9±3.0^a	25.7±2.8^a
高量组	50	15.1±1.9	27.3±3.1^a	26.0±2.9^a
F值		0.934	25.371	18.914
P值		0.327	<0.001	<0.001

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