摘要
目的探讨经皮后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩骨折 （osteoporoticvertebral body compression fracture,OVCF）并发骨水泥渗漏的类型及临床意义。方法回顾性分析北京友谊医院2005年6月至2009年6月期间收治的123例PKP治疗0VCF患者的临床资料，手术椎体共402个，记录骨水泥渗漏部位及骨水泥渗漏给患者带来的临床症状以及术前、术后3d、术后6个月随访时的疼痛视觉模拟评分，以评估疼痛缓解程度；相关数据统计运用SPSS13．0统计软件包，进行配对t检验。P〈0．05为差异有统计学意义，P〈0．01为差异有显著统计学意义。结果本组手术均一次性成功，术后发生渗漏36例52个椎体，渗漏率12．94％。按解剖位置对椎体外的局部骨水泥渗漏共分7型。临床随访6～30个月，平均16个月。除1例骨水泥渗漏至椎管内硬膜外患者术后出现同侧下肢疼痛及肌力减退外，其余患者均无明显临床表现。结论a）经皮后凸成形术治疗骨质疏松性椎体压缩骨折是一种有效、安全的微创手术，能够迅速地改善临床症状。b）按解剖位置对椎体外的局部骨水泥渗漏共分7型。穿刺针道渗漏和椎间盘渗漏发生率最高，但患者无明显临床症状，不影响手术疗效；椎管内渗漏发生率最低，但可产生脊髓神经症状等极少数严重后果。所以仍需尽量避免渗漏的发生。
Objective To investigate the classification and clinical value of the bone cement leakage in percutaneous kyphoplasty （PKP） for osteoporotic vertebral body compression fracture （OVCF）. Methods From June 2005 to June 2009 in Beijing Friendship Hospital, 123 patients with OVCF were treated with PKP,there were 402 compressed and fractured vertebral bodies. Record the location of bone cement leakage, the clinical results complicated by bone cement leakage,and the visual analog scale of pain（VAS）of preoperation, 3 days postperation and 6 months post- peration. The statistical data was analyzed and adopted the matched t-test by using SPSS 13. 0 statistic software. There were significances in statistics when P〈0.05,and obvious significances in statistics when P〈0. 01. Results Obvious pain relief was achieved in all the patients after operation. 36 cases and 52 vertebral bodies had bone cement leakage,the leakage ratio was 12. 94%,and The local bone cement leakage was classified into 7 types by anatomical location. During the follow-up period of 6-30 months ,besides one patient in one case of spinal canal leakage had a diminished muscle force in the same side of lower extremity ,all the rest patients got no marked clinical symptoms. Conclusion For OVCF,PKP is a mini-invasive,effective and safe procedure that provides pain relief and stabilization of spinal stability. The local bone cement leakage was classified into 7 types by anatomical location,puncture tube leakage and intervertebral leakage had the highest rate of occurrence,but the patients have no eilinieal symptom,which has no influence of curative effect of the operation,although spinal canal leakage had the lowest rate of occurrence,it could cause serious consequences of symptoms of spinal and nerve root injury. So it is necessasy to try to avoid the occurrence of bone cement leakage.
出处
《实用骨科杂志》
2011年第6期490-494,共5页
Journal of Practical Orthopaedics
关键词
经皮后凸成形术
骨质疏松
椎体压缩骨折
并发症
骨水泥渗漏
percutaneous kyphoplasty
osteoporosis
vertebral body compression fracture
complications
bone cement Leakage
