CAJ | 학술논문

目的：探讨骨质疏松性椎体压缩性骨折经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗后椎体内骨水泥分布形态对手术效果的影响。方法选择2006年1月—2013年12月行 PVP 和 PKP 治疗的骨质疏松性椎体压缩性骨折440例591节椎体，根据术后 X 线片骨水泥椎体内分布形态分为致密型组370例，弥散型组70例。比较两组手术时间、透视次数、骨水泥量、住院天数、术后视觉模拟评分(VAS)、改良 Oswsetry 功能障碍指数(ODI)、Cobb's 角、椎体前后缘高度比、骨折部位和手术方法、骨水泥漏及新发椎体骨折发生率。结果平均随访36个月，弥散型组手术时间长于致密型组，骨水泥渗漏率高于致密型组(P <0．01)，其他指标两组比较差异无统计学意义(P >0．05)。两组各发生手术椎体再骨折1例，均给予相应治疗。结论椎体内骨水泥呈弥散型分布易发生骨水泥漏，术中透视应多加注意，以防止严重并发症的发生。
목적：탐토골질소송성추체압축성골절경피추체성형술(PVP)화경피추체후철성형술(PKP)치료후추체내골수니분포형태대수술효과적영향。방법선택2006년1월—2013년12월행 PVP 화 PKP 치료적골질소송성추체압축성골절440례591절추체，근거술후 X 선편골수니추체내분포형태분위치밀형조370례，미산형조70례。비교량조수술시간、투시차수、골수니량、주원천수、술후시각모의평분(VAS)、개량 Oswsetry 공능장애지수(ODI)、Cobb's 각、추체전후연고도비、골절부위화수술방법、골수니루급신발추체골절발생솔。결과평균수방36개월，미산형조수술시간장우치밀형조，골수니삼루솔고우치밀형조(P <0．01)，기타지표량조비교차이무통계학의의(P >0．05)。량조각발생수술추체재골절1례，균급여상응치료。결론추체내골수니정미산형분포역발생골수니루，술중투시응다가주의，이방지엄중병발증적발생。
Objective To explore the distribution pattern of bone cement on efficacy after the percutaneous ver-tebroplasty ( PVP) and percutaneous kyphoplasty ( PKP) in treatment of osteoporotic vertebral compression fractures (OVCFS). Methods According to cement distribution in vertebrates shown by postoperative X-ray plate, 440 patients (591 vertebraes) with osteoporotic vertebral compression fractures during January 2006 and December 2013 were divided into dense type group (n = 370) and diffusion type group (n = 70). The operation time, X-ray frequency, volume of bone cement, hospital stay, postoperative visual analogue scales (VAS), improved Oswesty dysfunction indexes (ODI), Cobb's angle, the ratio of anterior height/ posterior height of vertebrae edges, fracture parts, surgical methods, incidence rates of cement leakage and fresh fracture of vertebra body were compared in the two groups. Results All the patients were followed up for a mean of 36 months, and the operation time was longer and incidence rate of cement leakage was higher in diffusion type group than those in dense type group (P < 0. 01), while the differences in other indexes were not statistically significant (P > 0. 05). Conclusion Bone cement leakage is often found in the diffusion type, so more at-tention must be paid during the surgery in order to prevent incidence of severe complications.