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目的比较经皮椎体成形(PVP)术中应用高粘度骨水泥和Genex液态人工骨填充治疗骨质疏松性椎体压缩骨折的疗效。方法回顾性分析自2012-09—2014-01采用高粘度骨水泥(骨水泥组)和Genex液态人工骨(Genex组)行PVP治疗的84例骨质疏松性椎体压缩骨折。术后1 d、6个月、1年分别采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评价患者的疼痛和生活质量改善情况,摄X线片计算伤椎椎体前缘高度比(AVH)及伤椎Cobb角。结果 84例随访时间6~12个月,平均9个月。2组术后1 d、6个月、1年的VAS评分、ODI指数较术前明显降低,差异有统计学意义(P<0.05)。2组术后1 d、6个月、1年的AVH、伤椎Cobb角较术前有所恢复,但差异无统计学意义(P>0.05)。骨水泥组与Genex组术前及术后1 d、6个月、1年的VAS评分、ODI指数、AVH、伤椎Cobb角比较差异无统计学意义(P>0.05)。骨水泥组渗漏率明显低于Genex组,差异有统计学意义(χ2=9.82,P<0.01)。结论 PVP术中应用高粘度骨水泥和Genex液态人工骨填充治疗骨质疏松性椎体压缩骨折均可取得良好效果,但Genex液态人工骨渗漏率较高。
Objective To compare the effects of high viscosity cement and Genex liquid artificial bone filling in the treatment of osteoporotic vertebral compression fractures during percutaneous vertebroplasty (PVP). Methods Retrospective analysis of 84 cases of osteoporotic vertebral compression fractures treated with PVP with high viscosity cement (cement group) and Genex liquid artificial bone (Genex group) from September 2012 to January 2014. Pain visual analog scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the patients’ pain and quality of life at 1 d, 6 months and 1 year after operation. The anterior height (AVH) and Cobb angle of the injured vertebra. Results 84 cases were followed up for 6 to 12 months with an average of 9 months. The VAS score and ODI index of the two groups at 1 d, 6 months and 1 year after operation were significantly lower than those before operation (P <0.05). AVB and Cobb angle of injured vertebra at 1 d, 6 months and 1 year after operation were recovered in both groups, but the difference was not statistically significant (P> 0.05). VAS score, ODI index, AVH and Cobb angle of injured vertebrae in the group of cement and Genex were not statistically significant (P> 0.05) before and 1 d, 6 months and 1 year after operation. The bone cement leakage rate was significantly lower than Genex group, the difference was statistically significant (χ2 = 9.82, P <0.01). Conclusion The application of high viscosity cement and Genex liquid artificial bone filling in the treatment of osteoporotic vertebral compression fractures in PVP can achieve good results, but the leakage rate of Genex liquid artificial bone is high.