椎体成形术在胸腰段不稳定骨折中的应用  

The application of vertebroplasty in the treatment of thoracolumbar vertebra unstable fractures

作　　者：毛克亚[1] 王岩[1] 刘保卫[1] 刘郑生[1] 肖嵩华[1] 张永刚[1] 陶笙[1] 卢世璧[1] 王继芳[1] 

机构地区：[1]解放军总医院骨科,北京100853

出　　处：《临床骨科杂志》2006年第4期295-297,共3页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金资助项目(编号:39670731)

摘　　要：目的探讨碳酸化羟基磷灰石水泥（CHC）作为充填材料在椎体成形术治疗胸腰段不稳定椎体压缩骨折手术中的应用效果。方法22例胸腰段椎体不稳定压缩骨折患者采用椎弓根螺钉系统撑开复位和内固定，通过骨折椎体的椎弓根进行椎体成形术，在椎体内注入CHC增强椎体，观察其治疗效果。结果术后X线片显示，CHC固化后充填在椎体中前柱，与骨界面结合紧密，椎体的高度平均恢复到80％～100％（95％±3．6％）。随访24～36个月，均未出现椎弓根钉棒断裂和弯曲。结论胸腰段椎体不稳定压缩骨折采用椎弓根螺钉内固定同时行椎体成形术，椎体充填CHC可以有效恢复椎体前柱力学强度，降低椎弓根钉棒断裂的风险。Objective Using a new kind of bone graft carbonated hydroxyapatite cement（CHC） as augmented biomaterials to determine the efficacy of vertebroplasty in the operation of thoracolumbar unstable vertebra compression fractures. Methods 22 cases of thoracolumbar unstable vertea compression fractures were reduced with pedicle screws system, and then CHC was injected from the fracture vertebra pedicle to perform vertebroplasty to observe the effect. Results CHC was filled in the middle and anterior part of the fracture vertebra, and the interface was compact between CHC and bone. The height of fracture vertebra restore to 80% - 100% （95% - 3.6% ）. There was no pedicle screw system breakup and bending in the 24 - 36 months follow-up periods. Conclusions The anterior biomechanics of thoracolumbar unstable vertebra compression fractures could be restored by vertebroplasty filling with CHC after pedicle system internal fixation, and the pedicle screw system breakup risk decreased.

关 键 词：脊柱骨折 椎弓根螺钉 椎体成形术 碳酸化羟基磷灰石 

分 类 号：R618.5[医药卫生—外科学] R687.3[医药卫生—临床医学]