Bone filling mesh container for osteoporotic vertebral fractures with posterior vertebral wall breakage: it is effective for prevention of bone cement leakage

doi:10.3969/j.issn.2095-4344.2014.47.001

Abstract

Abstract:

BACKGROUND: Percutaneous kyphoplasty for osteoporotic vertebral fractures with posterior vertebral wall breakage can relieve pain rapidly, but there is a risk of leakage of bone cement.
OBJECTIVE: To observe the effect of bone filling mesh container in percutaneous kyphoplasty for osteoporotic vertebral fractures with posterior vertebral wall breakage.
METHODS: Forty senile patients with osteoporotic vertebral compression fractures were enrolled, whose CT and MRI showed different degrees of posterior vertebral wall breakage, including 19 males (21 vertebral bodies) and 21 females (28 vertebral bodies), aged 50-87 years. These 40 patients were subjected to percutaneous kyphoplasty, and bone filling mesh container was used to deliver bone cement. Then, changes in visual analogue scale score, vertebral height and leakage of bone cement were observed in patients before and after treatment.
RESULTS AND CONCLUSION: The surgery was successful in all the 40 patients, and no pulmonary embolism, cement leakage, and spinal cord and nerve root injuries appeared. All the patients were followed for 10-12 months. The visual analogue scale scores and vertebral height were improved significantly at both 1 week and 3 months after treatment compared with those before treatment, but there was no difference in the visual analogue scale scores and vertebral height at 1 week and 3 months after treatment. These findings indicate that percutaneous kyphoplasty with bone filling mesh container is effective to prevent bone cement leakage.

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

全文链接：

Key words: kyphoplasty, osteoporotic fractures, biocompatible materials

CLC Number:

R318

Bai Ming, Yin He-ping, Li Shu-wen, Du Zhi-cai. Bone filling mesh container for osteoporotic vertebral fractures with posterior vertebral wall breakage: it is effective for prevention of bone cement leakage[J]. Chinese Journal of Tissue Engineering Research, 2014, 18(47): 7545-7549.

Figures/Tables 2

References

[1] 胥少汀.实用骨科学[M].3版.北京:人民军医出版社,2005:1198.
[2] European Prospective Osteoporosis Study (EPOS) Group, Felsenberg D, Silman AJ,et al.Incidence of vertebral fracture in Europe : results from the European Prospective Osteoporosis Study(EPOS).J Bone Miner Res. 2002;17(4): 716-724.
[3] Nakano M,Hirano N,Matsuura K,et al.Pereutaneous transpedieular vertebroPlas with calcium PhosPhate eement in the treatrment of osteoPorotic vertebral compression and burst fractures.J Neurosurg.2002;97(3 Suppl):287-293.
[4] 郑召民,李佛保.经皮椎体成形术和后凸成形术的适应证及如何认识“预防性手术”[J].中国脊柱脊髓杂志,2007,17(11): 805-806．
[5] 王冰,朱裕成,马军,等.经皮后凸成形术在治疗多节段骨质疏松性椎体压缩性骨折的应用[J].临床骨科杂志,2012,15(1): 17-20.
[6] 王兴武,陈建猛,俞武良,等.经皮椎体成形术与后凸成形术治疗急性骨质疏松性轻度压缩骨折的疗效及成本比较[J].临床骨科杂志, 2012,15(2):125-128.
[7] Li H,Chen C,Zhang S,et al.The use of layer by layer self-assem-bled coatings of hyaluronic acid and cationized gelatin to improve the biocompatibility of poly (ethylene terephthalate)artificial liga-ments for reconstruction of the anterior cruciate ligament. Acta Biomater. 2012;8(11): 4007-4019.
[8] 郑召民.经皮椎体成形术和经皮椎体后成形术灾难性并发症—骨水泥渗漏及其预防[J].中华医学杂志,2006,86(43): 3027- 3030.
[9] Lee MJ,Dumonski M,Cahill P,et al.Percutaneous treat. Ment of vertebra compression fractures: a meta—analysis of complications.Spine(Phila Pa 1976).2009;34(11): 1228-1132.
[10] Bhatia C,Barzilay Y,Krishna M,et al.Cement leak-age in percutaneous vertebroplasty effect of preinjec-tion gelfoam embolization.Spine(Phila Pa 1976).2006;31(8):915-919.
[11] 曹渊武,姜晓幸.生物蛋白胶在椎体后凸成形术中应用的离体研究[J].中国临床医学,2009,16(6):934-936.
[12] 陈艺,白波,孙辉,等.可注射磷酸钙骨水泥在经皮椎体后凸成形术中的体外生物力学评价[J].中华生物医学工程杂志, 2007,13(4): 216.
[13] 孙钰,吴乃庆,曹晓建,等.硅胶薄膜囊预防椎体后凸成形术中骨水泥渗漏的实验研究[J].中国骨与关节损伤杂志, 2007,22(11): 913-915.
[14] 张爱明,李青,蔡林,等.CT成像Pin point激光导航系统引导下经皮椎体成形术治疗多节段胸腰椎骨折[J].医学新知杂志, 2009, 19(3):148-149,152.
[15] 赵刚,史相钦,崔宏勋,等.应用Sky治疗骨质疏松性胸腰椎骨折初步探讨[J].中国中医骨伤科杂志,2007,15(9):8-10.
[16] 郑召民,邝冠明,董智勇,等.新型Vessel-X骨材料填充器经皮椎体成形术(Vessel plasty)球囊扩张椎体后凸成形术的替代选择[J].中华医学杂志,2007,7(2):143-147.
[17] 杨长远,王文军,罗光平,等.新型脊柱外固定器联合椎体成形术治疗胸腰椎骨折[J].医学临床研究,2007,24(8):13.
[18] Hulme PA,Krebs J,Ferguson SJ,et al.Vertebroplasty and ky-phoplasty: a sustematic review of 69 clinical studies.Spine(Phila Pa 1976).2006;31(17):1983-2001.
[19] Taylor RS,Taylor RJ,Fritzell P,et al.Balloon kyphoplasty and vertebroplasty for vertebral compression fractures: a comparative systematic review of efficacy and safety. Spine (Phila Pa 1976).2006;31(23):2747-2755.
[20] Venmans A,Klazen CA,van Rooij WJ,et al.Postprocedural CT for perivertebral cement leakage in percutaneous vertebroplasty is not necessary--results from VERTOS II. Neuroradiology.2011;53(1):19-22.
[21] Wu ZX,Wei L,Hu YY,et al.Staged-injection procedure to prevent cement leakage during vertebroplasty: an in vitro study.J Surg Res.2010;164(2):e253-256.
[22] Yeom JS,Kim WJ,Choy WS,et al.Leakage of cement in percutaneous transpedicular vertebroplasty for painful osteoporotic compression fractures.J Bone Joint Surg(Br), 2003;85(1):83-89.
[23] Hadjipavlou AG,Tzermiadianos MN,Katonis PG,at el. Percutaneous vertebroplasty and balloon kyphoplasty for the treatment of osteoporotic vertebral compression fracturec and osteolytic tumours.J Bone Joint Surg Br. 2005;87(12): 1595-1604.