球囊扩张椎体后凸成形术治疗骨质疏松性脊柱压缩性骨折  

Treatment of Osteoporotic Spinal Compressive Fractures by Balloon Kyphoplasty

作　　者：宋柏杉[1] 陈天国[1] 茹选良[1] 

机构地区：[1]浙江省杭州市浙江医院骨科,310013

出　　处：《中国骨与关节损伤杂志》2005年第7期440-442,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨球囊扩张椎体后凸成形术治疗骨质疏松性脊柱压缩性骨折的疗效和安全性.方法自2003年1月～2004年10月采用球囊扩张椎体后凸成形术(kyphoplasty)治疗骨质疏松性脊柱压缩性骨折18例19椎,均为新鲜骨折,腰背部疼痛剧烈,无神经症状和体征.在C型臂X线机透视下,采用经皮穿刺经两侧椎弓根在伤椎内置入2枚球囊扩张后使塌陷椎体复位后,将含钡骨水泥灌注入球囊扩张后所形成的空腔内.观察术后疼痛的改善程度,骨折复位情况及并发症.结果18例手术经过顺利,术后疼痛均有明显缓解或消失,术后24 h均可下地活动,X线片示骨折后突畸形平均矫正14°(11°～17°),3例有少量骨水泥渗漏至椎体两侧,无临床症状;2例术后出现不全性肠梗阻,经非手术治疗而治愈,无其他严重并发症.结论球囊扩张椎体后凸成形术治疗骨质疏松性脊柱压缩性骨折具有创伤小、止痛效果好、安全性高,并能恢复脊柱的稳定性和正常序列.Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment ot osteoporotic spinal compressive fractures. Methods Eighteen cases of osteoporotic spinal compressive fractures were treated by balloon kyphoplasty from Feb 2003 to Oct 2004. They were all fresh fractures and caused severe back pain, but no neurosis symptom and sign were found. Two balloons were inserted into vertebra through pedicle of vertebral arch by percutaneous puncture under guidance of C- typed arm X - ray unit. The balloons were then expended to restore the vertebral body. The body was then kept by casting bone cement. The pain relieve, the degree of reposition and complications were observed. Results Eighteen patients were operated smoothly. The pains were relieved or vanished completely. They all got up and walked after 24 hours of operation. Processus aboralis of fracture vertebras were corrected by mean 14degree （11 -14 degree）. A little amounts of bone cement leaked in three cases without clinical symptoms. Bowel obstruction happened in two cases and was cured after expectant treatment. Conclusion Balloon kyphoplasty is a safe and minimal invasive surgery way that relieves pain and improves spinal alignment in the treatment of osteoporotic spinal compressing fractures.

关 键 词：球囊扩张 椎体 后凸成形术 骨质疏松性 脊柱压缩性骨折 手术方法 

分 类 号：R683.2[医药卫生—骨科学]