强化骨质疏松椎弓根螺钉治疗老年腰椎疾患  

Augmented pedicle screw fixation with bone cement in the treatment of old patients with degenerative lumbar disease

作　　者：李春华[1] 樊仕才[1] 金大地[2] 瞿东滨[2] 王宏波[1] 周新强[1] 彭军[1] 刘世学[1] 

机构地区：[1]广州医学院附属深圳沙井医院骨二科,广东深圳518104 [2]南方医科大学附属南方医院脊柱骨病科,广东广州510515

出　　处：《临床骨科杂志》2009年第2期150-152,共3页Journal of Clinical Orthopaedics

摘　　要：目的评价骨水泥强化骨质疏松椎弓根螺钉治疗老年腰椎疾患的临床疗效。方法对22例老年腰椎疾病患者行骨水泥强化椎弓根螺钉、椎间植骨融合。术前测量待植入螺钉之椎体的骨密度;术中测量螺钉的最大旋入力偶矩;用3 ml骨水泥强化椎弓根螺钉,测量螺钉的最大旋入力偶矩;减压后行椎间植骨融合术。结果患者均未发生手术并发症,腰腿痛治愈、好转20例,2例症状无明显改善。强化椎弓根螺钉后,螺钉的最大旋入力偶矩由(0.591±0.213)Nm增至(1.332±0.377)Nm,差异有显著性(P<0.01)。影像学表现为骨水泥分布于钉道周围松质骨中,未出现椎体外渗漏。结论骨水泥强化骨质疏松椎弓根螺钉治疗老年腰椎疾患能明显增强螺钉的稳定性。Objective To evaluation the clinical effect of augmented pedicle screw fixation with polymethylmethacrylate （PMMA） bone cement in the treatment of old patients with degenerative lumbar disease. Methods 22 cases with lumbar degenerative lumbar diseases were included in this study. Bone density was measured preoperative and insertional torque was measured before fixation. Pedicle screws were augmented with PMMA and 10 minute later insertional torque was measured again. Bone graft and fixation were completed after decompression. Results There was no complication happened intra- and post-operatively. The clinical effect of 20 cases with low back pain were excellent and good, and 2 cases were fair. The insertional torque of pediele screw had enhanced from （0.591±0. 213 ） Nm to （1. 332±0. 377） Nm after augmented with PMMA. There was significant difference （P 〈 0.01 ）. Radiology images showed cement was around the trajectories of screws. Conclusions Augmentation pediele screw with PMMA in the treatment of lumbar degenerative lumbar disease can enhance the stability of serew significantly.

关 键 词：骨水泥 强化 椎弓根螺钉 骨质疏松 脊柱疾病 

分 类 号：R681.5[医药卫生—骨科学] R687.3[医药卫生—外科学]