椎体后凸成形术与椎体成形术的比较  

Comparative study of kyphoplasty and vertebroplasty

作　　者：唐迎九[1] 杨惠林[2] 章洪喜[1] 王海[3] 陈文忠[4] 苏虹[5] 

机构地区：[1]江苏大学附属人民医院骨科,江苏镇江212002 [2]苏州大学附属第一医院骨科,江苏苏州215006 [3]江苏大学附属人民医院CT室,江苏镇江212002 [4]江苏大学附属人民医院放射科,江苏镇江212002 [5]江苏大学理学院,江苏镇江212013

出　　处：《江苏大学学报（医学版）》2010年第1期64-67,共4页Journal of Jiangsu University：Medicine Edition

基　　金：镇江市社会发展基金资助项目(SH2004027)

摘　　要：目的:通过脊椎标本的离体试验比较椎体后凸成形术与椎体成形术治疗椎体压缩性骨折的效果。方法:20个骨质疏松性脊椎标本,相邻脊椎配对后随机分配到球囊扩张椎体后凸成形术组(KP组)及椎体成形术组(VP组)。椎体轴向加载后复制成压缩性骨折模型。两组标本分别按照KP或VP标准技术注入骨水泥。观察椎体原始状态、复制骨折模型及KP或VP治疗后的椎体高度,同时行CT扫描,观察骨折复位、骨水泥分布及渗漏情况。结果:KP组可恢复骨折椎体丢失高度的88%;VP组仅恢复29%,差异显著(P<0.01)。KP组骨水泥在椎体内的分布呈团块状,未发现有骨水泥外渗漏;而VP组骨水泥分布不规则,4个椎体标本出现骨水泥外渗漏。结论:对于体外椎体骨折模型椎体高度的恢复和减少骨水泥渗漏,KP明显优于VP。Objective ： To compare kyphoplasty （KP） or vertebroplasty （VP） in treatment of osteoporotie vertebral compression fractures by an in vitro experiment. Methods： Twenty osteoporotic vertebrae were randomly assigned to KP or VP group after pairing of adjacently vertebral bodies. Vertebral compression fracture models were created by axial loading, then kyphoplasty and vertebroplasty were performed on both groups respectively. The vertebral height of initial samples, fracture models and postoperative vertebral bodies were observed, while the character of bone cement distributing in vertebral body and the event of bone cement leakage from vertebral body were compared from computerized tomography scaning pictures. Results： The kyphoplasty treatment resulted in significant restoration （88%） of vertebral body height lost after compression, whereas vertebroplasty treatment resulted in a significantly lower restoration of lost height （28%）, the difference was significant （P 〈 0.01 ）. In KP group, the cement distribution was agglomerate in vertebral bodies, no leakage was found. But in VP group, the cement distribution was irregular and cement leakage events were found in 4 vertebral models. Conclusion： Kyphoplasty was superior to vertebroplasty in restoring vertebral body height with a lower incidence rate of cement extravasation.

关 键 词：骨质疏松症 脊椎骨折 椎体后凸成形术 椎体成形术 

分 类 号：R683.2[医药卫生—骨科学]