经皮椎体后凸成形术(PKP)结合可注射硫酸钙(MIIG X3)治疗胸腰椎骨质疏松性压缩骨折  

Clinical results of percutaneous kyphoplasty (PKP) with MIIG X3 in the treatment of osteoporotic thoracolumbar compression fractures

作　　者：赵磊[1] 王黎明[1] 王钢锐[1] 徐杰[1] 曾逸文[1] 徐燕[1] 

机构地区：[1]南京医科大学附属南京第一医院骨科,南京210006

出　　处：《中国骨质疏松杂志》2007年第6期424-428,共5页Chinese Journal of Osteoporosis

摘　　要：目的总结2003年4月-2006年6月应用经皮椎体后凸成形术（PKP）结合可注射硫酸钙（MIIGX3）治疗胸腰椎骨质疏松性压缩骨折的经验和体会。方法本组33例患者,男20例,女13例;年龄55-82岁,平均66.4岁;在“C”臂机引导下,采用经皮穿刺方法,经椎弓根将一中空管道置入伤椎建立工作通道,利用球囊膨胀的张力将伤椎椎体松质骨向四周挤压,使伤椎恢复高度并产生空腔,经“C”臂机确认伤椎复位满意后记录球囊压力及容量,取出球囊,将同等量MIIGX3人工骨注入空腔内,通过“C”臂机确认MIIGX3人工骨充满空腔后完成手术。采用疼痛视觉类比评分（VAS）、伤椎高度测定及胸腰椎后凸畸形角度测量等指标评估PKP术的近期疗效。结果全部病例疼痛完全解除或者有明显缓解,经X线检查压缩骨折的椎体高度恢复满意,后凸畸形平均矫正14°（10°-22°）,无手术并发症。随访6个月以上,患者恢复伤前生活方式,无疼痛,伤椎高度无丢失。结论椎体后凸成形术（PKP）结合可注射硫酸钙（MIIGX3）治疗胸腰椎骨质疏松性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,重建脊柱稳定性,具有较好的近期治疗效果。Objective To evaluate the effect of percutaneous kyphoplasty（PKP） with injectable calcium sulfatebased bone graft substitute （minimally invasive injectable graft X3 MIIG X3 ） in managing asteoporotic thoracolumbar compression fractures from April 2003 to June 2006. Methods Thlrty-three patients（20 male and 13 female） of osteoporotic tboracolumbar compression fractures（ age group from 55 to 82, average 66.4 years old） were treated with transpedicular balloon kyphoplasty under ＂C＂ armed imaging guiding. The inflatable bone tamp was inserted into the fractured vertebral body transpedicularly in a minimally invasive way. The balloon was inflated, elevating the endplate and restoring vertebral body height and then confirmed by ＂C＂ armed imaging. The balloon was deflated and withdrawn, leaving a cavity within the vertebral body. The cavity was then filled with MIIGX3 artificial bone, creating an ＂internal cast＂ which was also confirmed by ＂C＂ armed imaging. Patients were evaluated with visual analogue scale （VAS）, the height restoration of vertebral body and the Cobb angle of kypbosis. Results Marked or complete pain relief was achieved in all patients. The height restoration of vertebral body and correction of kyphosis were confirmed by X-ray after the procedure. The average correction of kyphosis was 14°10°- 22°）. After 6 months＇ follow-up, all 33 cases retained the life style as before injury, there was no back pain, and deformity correction was maintained well. No complications occurred. Conclusion PKP with MIIG X3 is a minimally invasive, effective and safe procedure that provides pain relief and stabilization of spinal stabihty.

关 键 词：椎体后凸成形术 可注射硫酸钙 胸腰椎压缩性骨折 骨质疏松症 

分 类 号：R687.3[医药卫生—骨科学]