中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (42): 7947-7950.doi: 10.3969/j.issn.1673-8225.2010.42.038

• 生物材料临床实践 clinical practice of biomaterials • 上一篇    下一篇

经皮椎体后凸成形治疗中骨水泥渗漏对椎体高度恢复的影响

张  辉，章  涛，张平方，董  红，王建民   

  1. 华北石油总医院骨科，河北省任丘市 062552
  • 出版日期:2010-10-15 发布日期:2010-10-15
  • 作者简介:张辉☆，男，1971年生，河北省献县人，博士，副主任医师，主要从事脊柱脊髓损伤的临床研究。 zt2008year@sina.com 并列第一作者： 章涛，男，1973年生，湖南省祁阳市人，汉族，在读硕士，主治医师，主要从事脊柱脊髓损伤的临床研究。

Bone cement leakage in percutaneous kyphoplasty for the recovery of vertebral height

Zhang Hui, Zhang Tao, Zhang Ping-fang, Dong Hong, Wang Jian-min   

  1. Department of Orthopedics, General Hospital of Huabei Oil Field Company, Renqiu   062552, Hebei Procince, China
  • Online:2010-10-15 Published:2010-10-15
  • About author:Zhang Hui☆, Doctor, Associate chief physician, Department of Orthopedics, General Hospital of Huabei Oil Field Company, Renqiu 062552, Hebei Procince, China Zhang Tao, Studying for master’s degree, Attending physician, Department of Orthopedics, General Hospital of Huabei Oil Field Company, Renqiu 062552, Hebei Procince, China zt2008year@sina.com Zhang Hui and Zhang Tao contributed equally to this paper.

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345

被引次数

3

摘要：

背景：将经皮椎体后凸成形通过球囊加压扩张在椎体内形成周围有相对致密松质骨的空腔，可有效降低骨水泥渗漏率，同时扩张的球囊有助于塌陷椎体的复位，矫正脊柱后凸畸形。
目的：回顾性分析手法复位后将经皮椎体后凸成形注入骨水泥治疗骨质疏松性椎体压缩骨折渗漏情况及对椎体高度恢复的影响。
方法：选择2008-02/2010-06华北石油总医院骨科行经皮椎体后凸成形治疗骨质疏松性椎体压缩骨折患者31例，41椎体。平均年龄69(53~82)岁。并于术前手法按压使腰部过伸复位。观察患者术后疼痛缓解、椎体高度恢复以及骨水泥渗漏情况。
结果与结论: 所有患者术后随访8~13(11.0±1.6)个月。患者视觉模拟疼痛评分由术前6.7±1.9下降至术后1.3±1.2，差异有显著性意义(P < 0.05)。椎体高度由术前(15.7±5.2) mm恢复至(20.2±4.5) mm，椎体高度显著恢复(P < 0.05)。发生骨水泥渗漏3例，均无明显临床症状。说明术前手法复位后经皮椎体后凸成形将骨水泥注入骨质疏松性椎体压缩骨折可以显著恢复椎体高度，止痛效果良好且无严重渗漏发生。

关键词: 经皮椎体后凸成形, 骨质疏松, 骨质疏松性椎体压缩骨折, 骨水泥, 生物材料

Abstract:

BACKGROUND: The percutaneous kyphoplasty may form a cavity with surrounding relatively tight cancellous bone in vertebral body through balloon compression expansion, can effectively reduce the leakage rate of bone cement, at the same time the expanding balloon contributes to reduce collapsed vertebral body and correct kyphosis.
OBJECTIVE: To retrospectively analyze the influence of manual reduction combined with percutaneous kyphoplasty bone cement on fracture leakage and vertebral height restoration in treatment of osteoporotic vertebral compression fracture.
METHODS: Thirty-one patients (41 vertebras) with osteoporotic vertebral compression fracture, aged 53-82 years at a mean of 69 years, were treated with manual reduction and percutaneous kyphoplasty from February 2008 to June 2010 in Department of Orthopedics, General Hospital of Huabei Oil Field Company. Prior to operation, the lumbar part was over-extending reduction by manipulation. The postoperative pain relief, vertebral height restoration and bone cement leakage were recorded during follow-up.
RESULTS AND CONCLUSION: All the patients were involved in follow-up for 8-13 months, with an average (11±1.6) months. The visual analogue scale was reduced from (6.7±1.9) points preoperation to (1.3±1.2) points postoperation, with significant differences (P < 0.05). The vertebral height was restored from (15.7±5.2) mm preoperation to (20.2±4.5) mm postoperation, with significant differences (P < 0.05). Extra vertebral leakage of bone cement was observed in three vertebrae with no marked clinical symptoms. Manual reduction combined with percutaneous kyphoplasty is a safety method for osteoporotic vertebral compression fracture, for advantages of pain relief, significant restoration of the vertebrae height and minor the leakage of bone cement.

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