中国组织工程研究

中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (29): 5465-5468.doi: 10.3969/j.issn.2095-4344.2012.29.030

• 生物材料学术探讨 biomaterial academic discussion • 上一篇    下一篇

骨水泥植入经皮椎体成形治疗胸腰椎体骨折

柳申鹏，刘中何，赵 斌，徐海斌   

  1. 新乡医学院第一附属医院骨外科，河南省卫辉市 453100
  • 收稿日期:2012-03-04 修回日期:2012-06-02 出版日期:2012-07-15 发布日期:2012-07-15
  • 作者简介:柳申鹏★，男，1974年生，河南省滑县人，汉族，2006年甘肃中医学院毕业，硕士，主要从事创伤、脊柱、关节专业。 xilimeiliuyang@ 163.com

Bone cement implantation during percutaneous vertebroplasty for the treatment of thoracolumbar vertebral fractures

Liu Shen-peng, Liu Zhong-he, Zhao Bin, Xu Hai-bin   

  1. Department of Orthopedics, First Afiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China
  • Received:2012-03-04 Revised:2012-06-02 Online:2012-07-15 Published:2012-07-15
  • About author:Liu Shen-peng★, Master, Department of Orthopedics, First Afiliated Hospital of Xinxiang Medical University, Weihui 453100, Henan Province, China xilimeiliuyang@ 163.com

PDF

711

被引次数

26

摘要：

背景：近年来，经皮椎体成形作为一种安全有效的微创手术广泛应用于治疗骨质疏松性压缩骨折和椎体肿瘤引起的溶骨性骨破坏，获得了满意的效果。
目的：从骨水泥角度，探讨骨水泥与椎体成形治疗胸腰椎骨折疗效的关系。
方法：以“椎体成形术，腰椎，胸椎，椎体骨折，骨水泥”；“pereutaneous vertebroplasty，PVP，thoracic vertebra，lumbar vertebra，vertebral fracture，bone cement”为关键词检索维普数据库和Pubmed数据库，纳入与经皮椎体成形、骨水泥植入临床研究相关的文章，以22篇文献为重点进行了讨论。临床验证选择新乡医学院第一附属医院骨外科收治的40例(56个椎体)胸腰椎体骨折引起的疼痛患者，在 C形臂X射线机引导下，经皮穿刺完成椎体成形手术，观察术后疼痛改善，并分析并发症发生情况。
结果与结论：目前在经皮椎体成形中常用的骨水泥有聚甲基丙烯酸甲酯骨水泥、磷酸钙骨水泥、硫酸钙骨水泥等。目前仍不清楚为骨折愈合提供足够稳定和预防疼痛所需要的骨水泥量及成分比，但应尽量使用小剂量的骨水泥，且使骨水泥分布均匀，同时应根据病变椎体的不同情况，选择合适的注射方式，防止骨水泥渗漏与新椎体骨折。临床验证结果说明经皮椎体成形可以有效止痛，术后随访显示止痛效果与注入骨水泥的量无正相关，且不随着时间的推移而减弱。

关键词: 骨水泥, 椎体成形术, 腰椎, 胸椎, 椎体骨折, 生物材料

Abstract:

BACKGROUND: In recent years, percutaneous vertebroplasty as a safe and effective minimally invasive surgery has been widely used in the treatment of osteoporotic compression fractures and vertebral tumor-induced osteolytic bone destruction, and has obtained satisfactory results.
OBJECTIVE: To explore the correlation between bone cement and the curative effect of thoracolumbar vertebral fractures by percutaneous vertebroplasty.
METHODS: The VIP database and PubMed database were used to search the articles related to the clinical research of percutaneous vertebroplasty and bone cement implantation with the key words of “pereutaneous vertebroplasty, PVP, thoracic vertebra, lumbar vertebra, vertebral fracture, bone cement” in Chinese and English, respectively. A total of 22 articles were included to review. Forty cases (56 vertabral bodies) with the pain induced by thoracolumbar vertebral fractures were selected from the Department of Orthopedics, the First Affiliated Hospital of Xinxiang Medical University for the clinical validation. The percutaneous vertebroplasty was completed under the guidance of C-arm X-ray machine. The improvement of pain was observed after surgery, and the occurrence of the complications was analyzed.
RESULTS AND CONCLUSION: At present, the commonly used pereutaneous vertebroplasty bone cement includes polymethyl methacrylate bone cement, calcium phosphate cement and calcium sulfate bone cement. The volume and the composition of bone cement required for the sufficient stability of fracture healing and prevention of pain is remains unclear, but we should try to use small doses of bone cement and make the bone cement evenly distributed. Meanwhile, we should select an appropriate injection method based on different situations of the vertebra in order to prevent the leakage of bone cement and new vertebral fractures. The clinical validation results show that percutaneous vertebroplasty is an effective analgesic method, and postoperative follow-up shows that the analgesic effect and the injection amount of bone cement has no positive correlation, and the pain will not weakened over time.

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