中国组织工程研究

中国组织工程研究 ›› 2022, Vol. 26 ›› Issue (22): 3598-3601.doi: 10.12307/2022.291

• 生物材料综述 biomaterial review • 上一篇    下一篇

椎体增强术中降低骨水泥渗漏率的措施

杨  柳1，杜建伟2   

  1. 1大连医科大学，辽宁省大连市   116041；2扬州大学附属医院，江苏省扬州市   225000
  • 收稿日期:2021-03-03 修回日期:2021-04-10 接受日期:2021-06-12 出版日期:2022-08-08 发布日期:2022-01-13
  • 通讯作者: 杜建伟，博士，硕士生导师，副主任医师，扬州大学附属医院，江苏省扬州市 225000
  • 作者简介:杨柳，男，1997年生，湖北省咸宁市人，汉族，大连医科大学在读硕士。
  • 基金资助:


Measures to reduce the leakage rate of bone cement during vertebral augmentation

Yang Liu1, Du Jianwei2   

  1. 1Dalian Medical University, Dalian 116041, Liaoning Province, China; 2Affiliated Hospital of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
  • Received:2021-03-03 Revised:2021-04-10 Accepted:2021-06-12 Online:2022-08-08 Published:2022-01-13
  • Contact: Du Jianwei, MD, Master’s supervisor, Associate chief physician, Affiliated Hospital of Yangzhou University, Yangzhou 225000, Jiangsu Province, China
  • About author:Yang Liu, Master candidate, Dalian Medical University, Dalian 116041, Liaoning Province, China

PDF

51

摘要：

文题释义：
椎体增强手术：是指向压缩椎体内注入骨水泥使椎体恢复一定的强度与高度的一项技术，就目前来说，经皮椎体成形与椎体后凸成形是临床上使用最多的两种术式。骨水泥渗漏是这一手术的常见并发症，因为骨水泥渗漏而引起的严重临床后果屡见不鲜，降低骨水泥渗漏率使革新椎体增强术成为了目前临床上的热门话题。
骨水泥渗漏：是椎体成形术最常见的并发症之一，渗漏部位不同产生的临床后果也不同，最常见的渗漏部位是椎旁组织漏，而后果最严重的是椎管内漏，会压迫脊髓，产生一系列神经系统症状。能否降低术中骨水泥渗漏率是影响患者恢复的关键，包括改良手术方式、调整骨水泥成分等方法。

背景：目前椎体增强手术已成为治疗骨质疏松性椎体压缩性骨折的首选方法，如何降低术中骨水泥渗漏率引起了临床工作者的重视。
目的：就目前临床上在手术方式、骨水泥自身因素等方面对降低骨水泥渗漏率的研究做一综述。
方法：应用计算机检索PubMed、万方、知网数据库中1987-2021年间关于椎体增强术中骨水泥渗漏的相关文章，英文检索词为“cement leakage，vertebral augmentation，osteoporotic vertebral compression fractures”，中文检索词为“骨水泥漏，椎体增强术，骨质疏松性椎体压缩骨折”，排除与研究内容无关和内容重复的文章，保留43篇文章进行综述。
结果与结论：椎体增强手术分为多种术式，其中经皮椎体成形与椎体后凸成形是最常见的两种术式，椎体后凸成形更能降低骨水泥渗漏率。骨水泥自身因素例如骨水泥种类、黏度、注入量等也能影响骨水泥渗漏率。骨水泥渗漏的临床后果与其渗漏类型相关，其中最常见的是椎旁漏，并发症最严重的是椎管内漏。随着研究的深入，临床工作者们创新了很多应对骨水泥渗漏的技术，但效果不太明显，机器人辅助椎体成形是一个值得付诸临床实践的技术，相信随着技术的不断更新发展，骨水泥渗漏这一问题会得到有效解决。

https://orcid.org/0000-0002-4948-5016 (杨柳) 

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

关键词: 椎体增强术, 骨质疏松, 椎体压缩性骨折, 经皮椎体成形术, 椎体后凸成形术

Abstract: BACKGROUND: At present, vertebral augmentation has become the prior choice for the treatment of osteoporotic vertebral compression fractures. How to reduce the leakage rate of intraoperative bone cement has attracted the attention of clinical workers.
OBJECTIVE: To review the current clinical research on reducing the leakage rate of bone cement in terms of surgical methods and bone cement factors.
METHODS: PubMed, Wanfang, and CNKI databases were searched for articles about bone cement leakage during vertebral augmentation published from 1987 to 2021 with the key words of “cement leakage, vertebral augmentation, osteoporotic vertebral compression fractures” in Chinese and English. The articles which were irrelevant and repetitive were excluded, and 43 articles were reserved for review.
RESULTS AND CONCLUSION: Vertebral augmentation surgery has various surgical methods. Percutaneous vertebroplasty and kyphoplasty are the two most common methods. Kyphoplasty can reduce the leakage rate of bone cement. The factors of bone cement itself, such as the type of bone cement, viscosity and injection volume, can also affect the leakage rate of bone cement. The clinical consequence of bone cement leakage is related to the type of leakage, and the most common is paravertebral leakage; and the most serious complication is intraspinal leakage. With the deepening of research, clinical workers have innovated many technologies to deal with bone cement leakage, but the effect is not obvious. Robot assisted vertebroplasty is a technology worthy of clinical practice. It is believed that with the continuous update and development of technology, the problem of bone cement leakage will be effectively solved.

Key words: vertebral augmentation, osteoporosis, vertebral compression fracture, percutaneous vertebroplasty, kyphoplasty

中图分类号: