关键词: 骨质疏松, 骨折, 压缩性, 椎体成形术, 骨水泥

Abstract:

Objective： To analyze the outcomes of patients with osteoporotic vertebral compression fractures treated with polymethylmethacrylate (PMMA) and GeneX bone cement in percutaneous kyphoplasty and to provide guidance in selecting the vertebral filling material for this procedure. Methods: In this study, 86 patients with osteoporotic vertebral compression fractures treated at Peking University Third Hospital between June 2012 and June 2013 were retrospectively analyzed. The patients were followed-up with questionnaires and X-ray and CT examinations after 1 month, 3 months, 6 months, and 1 year. Postoperative conditions, including recovery rate of vertebral height, recovery rate of vertebral Cobb angle, CT data, reductions in visual analogue scale (VAS) and Oswestry scores, and postoperative complications, were evaluated. The results were analyzed using SPSS 18.0. Results: According to the rank sum test, there were significant differences in the recovery rate of vertebral height, vertebral Cobb angle and vertebral volume between the two groups after 3 months, 6 months, and 1 year (P<0.05). The GeneX-group had greater losses in vertebral height, Cobb angle and volume than did the PMMA group. The PMMA group had 3 cases of cement leakage and 1 case of an adjacent vertebral fracture after percutaneous kyphoplasty. The GeneX- group had 2 cases of cement leakage. Conclusion: GeneX- bone cement is similar to PMMA in terms of postoperative pain relief. As the filling material in percuta-neous kyphoplasty, it is effective at maintaining vertebral height, quickly improves strength and stiffness of the vertebral body and has fewer complications. However, it is not satisfactory in maintaining long-term postoperative vertebral height. GeneX- bone cement can be used as the filling material for patients with osteoporotic vertebral compression fractures in percutaneous kyphoplasty. Patients with severe osteoporosis and vertebral compression should be treated with standardized osteoporosis treatment and should try to avoid early postoperative walking exercises. Sustained vertebral filling materials, such as PMMA, are more suitable for such patients. Research into better biodegradable materials is still needed.

Key words: Osteoporosis, Fractures, compression, Vertebroplasty, Bone cement