PKP术中应用低温间断灌注技术治疗周壁破裂型OVCF

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Abstract Objective To explore the clinical efficacy of Low-temperature intermittent cement injection technique in the treatment of osteoporotic vertebral compression fracture with peripheral wall damage by percutaneous kyphoplasty(PKP)by comparing with temperature gradient cement injection technique.Methods A total of 60 patients，all of which were single vertebral fractures with osteoporotic vertebral fracture and peripheral wall damage from Jan.2015 to Dec.2018 were reviewed.According to the different methods of cement injection technique，the patients were divided into temperature gradient cement injection technique group and Low-temperature intermittent cement injection technique group，both groups included 30 patients separately.Outcomes were evaluated pre-and postoperative by using visual analogue score(VAS)，Oswestry disability index(ODI)，the local kyphosis angle，the anterior relative vertebral height ratio.Surgical duration，cement volume，cement distribution and the occurrence of cement leakage were compared between the two groups.Results The average follow-up of the two groups was(15.3±8.4)months and(18.6±8.2)months，and there was no significant difference between the two groups(P＞0.05).The VAS score and ODI were significantly improved after operation in both groups(P＜0.05).There was no significant difference between the final follow-up and postoperation in both groups(P＞0.05).The VAS score and ODI at postoperation and the final follow-up were significantly different between the two groups(P＜0.05)，while no statistical significance at the rest of the time(P＞0.05).As for the anterior relative vertebral height ratio and the local kyphosis angle，there was no significant difference at preoperation，postoperation and final follow-up(P＞0.05).The cement injectable working time in low-temperature intermittent cement injection technique group was significantly longer than that in temperature gradient cement injection technique group(P＜0.05)，but there was no significant difference in surgical duration(P＞0.05).The cement volume and cement distribution in low-temperature intermittent cement injection technique group was superior to temperature gradient cement injection technique group.Cement leakage occurred in only 2 patients，with a leakage rate of 6.7%，in low-temperature intermittent cement injection technique group，which was significantly lower than that of 26.7% in temperature gradient cement injection technique group(P＜ 0.05).Conclusion The application of low-temperature intermittent cement injection technique in the treatment of osteoporotic vertebral compressionfracture with peripheral wall damage by PKP can effectively prolong cement injectable working time，which is beneficial to increase cement volume and distribution in the vertebral body，and obtain better clinical results.Also，it can reduce the incidence of cement leakage.

Key words： kyphoplasty bone cement temperature gradient cement injection technique low-temperature intermittent cement injection technique cement leakage

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