Clinical efficacy of self-curing calcium phosphate bone cement(CPC)mixed with PMMA bone cement in the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty

Li Jianwei; Qi Xinsheng; Lin Qingxi; Sun Yong; Cui Yazhen

doi:10.3969/j.issn.1009-4237.2024.09.005

Abstract：Objective To explore the clinical effect of self-curing calcium phosphate bone cement(CPC)mixed with polymethylmethacrylate(PMMA)bone cement in percutaneous vertebroplasty(PVP)of osteoporotic vertebral compression fractures(OVCFs),and to analyze the postoperative complications.Methods A retrospective analysis was conducted on clinical data of 111 OVCF patients treated by PVP in the Orthopedics Department of Tai-kang Xianlin Gulou Hospital Affiliated to Nanjing University School of Medicine from Oct.2020 to Oct.2023,inclu-ding 20 males and 91 females aged 52-86(mean 67.8)years.There were 68 cases of falls,31 road traffic injuries,and 12 others.According to different fillers,patients were divided into PMMA group(filled with PMMA bone ce-ment,n=53)and mixed group(filled with a mixture of CPC and PMMA bone cement at a 1∶1 ratio,n=58).The pain,imaging indicators,functional impairment,quality of life,and complications were compared between the two groups.Results Compared with before surgery,the VAS of both groups decreased at 2 d,1,3 and 6 months after surgery(P＜0.05),but comparison between the two groups revealed no significant difference at all time points(P＞0.05).The Cobb angle and sagittal index of the vertebral body at 2 d,1,3 and 6 months after surgery neither re-vealed any significant differences compared with before surgery nor between the two groups(all P＞0.05).However,compared with before surgery,both groups at 1,3 and 6 months after surgery showed significantly reduced Oswestry dysfunction index(OD1,PM MA group:54.62±6.58,38.40±6.11,36.3±6.58 vs.75.19±8.97;Mixed group:55.52±6.22,35.57±6.20,32.62±4.22 vs.74.88±9.84)and Quality of Life Questionnaire of the European Foun-dation for Osteoporosis-41(QUALEFFO-41)scores(PMMA group:37.58±5.86,35.96±6.26,34.74±5.93 vs.66.30±9.09;Mixed group:39.02±5.70,32.66±5.19,31.64±4.98 vs.65.59±9.01,all P＜0.05),moreover,comparison between the two groups showed significantly lower ODI and QUALEFFO-41 scores in the mixed group at 3 and 6 months after surgery(all P＜0.05).But the PMMA group and mixed group showed similar total effective rate(98.1％vs.98.3％),bone cement leakage rate(15.1％vs.27.6％)and fracture rate of surrounding verte-brae(11.3％vs.19.0％,all P＞0.05).Conclusion In the treatment of OVCFs by PVP,the mixture of CPC and PMMA bone cement at a 1∶1 ratio can effectively improve functional impairment and quality of life and at the same time will not increase the incidence of complications,compared with PMMA alone.