椎体成形术后相邻椎体骨折的临床分析  

Clinical analysis of the adjacent vertebral fracture after vertebroplasty

作　　者：宋晋刚[1] 苗艳[2] 崔易坤[1] 尹振宇[1] 黄海锋[1] 

机构地区：[1]四川省绵阳市中心医院脊柱外科,621000 [2]四川省绵阳市人民医院骨科,621000

出　　处：《临床合理用药杂志》2012年第25期21-23,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析骨质疏松椎体压缩性骨折(OVCF)患者行经皮椎体成形术(PVP)后相邻椎体发生骨折的情况。方法对OVCF患者32例行PVP,术中数字减影血管造影(DSA)透视引导下经单侧或双侧椎弓根入路注入骨水泥。术后定期随访,观察其疗效及相邻椎体骨折发生情况。结果 32例患者术后随访12～24个月,平均16个月。术中骨水泥渗漏至椎间隙内5例,椎旁4例。32例患者中骨折38椎体,行PVP治疗22个椎体,行球囊扩张(PKP)治疗16个椎体。对伤椎术前高度与术后高度测量值、Cobb角进行比较,行PVP治疗者手术前后无明显差异(P>0.05),行PKP治疗者有明显差异(P<0.05)。疼痛再发患者5例,其中3例经MRI证实手术相邻椎体发生新鲜骨折。结论对OVCF患者行PVP安全有效,但注入骨水泥后应力集中、骨水泥渗漏椎间隙等因素增加了术后相邻椎体再次发生骨折的危险。Objective To research the adjacent vertebral fracture of patient with osteoporotic vertebral compression fractures（OVCF） after percutaneous vertebroplasty （PVP）. Methods 32 cases with OVCF were treated with PVP. Under fluoroscopic guidance of intraoperative digital subtraction angiography （ DSA ） , injected bone cement by unilateral or bilateral transpedicular. Postoperative followed-up regularly. Observed the efficacy and the situationn of adjacent vertebral fracture. Re- sults The patients were followed up for 12 ~24 months,average of 16 months. Bone cement leaked to the lateral vertebrae in 4 cases and to intervertebralspaee in 5 cases. In 32 cases patients （38 vertebral fractures） , with PVP treatment of 22 vertebral, with PKP treatment of 16 vertebral. Compared height and postoperative height of the measured value in the injured vertebral surgery and Cobb angle, before and after perattion to PVP treatment patients was no significant difference （P 〉 0.05 ）, the PKP treatment had significant difference（ P 〈 O. 05 ）. A total of 5 cases developed secondary back pain and 3 cases were new adja- cent vertebral body fracture based on the MRI findings. Conclusion The treatment of PVP for OVCF is safety. Stress concen- tration and bone cement leakage to intervertebral space increase risks for secondary fracture after PVP.

关 键 词：经皮椎体成形术 骨质疏松症 骨水泥 骨折 

分 类 号：R687.3[医药卫生—骨科学]