经皮椎体成形中的骨水泥分期注射  

Staged injection of bone cement in percutaneous vertebroplasty

作　　者：曾逸文[1] 许建安[1] 

机构地区：[1]南京中医药大学,江苏省南京市210000

出　　处：《中国组织工程研究》2013年第12期2116-2122,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:对于椎体骨皮质不完整的骨质疏松性椎体压缩骨折患者,经皮椎体成形治疗可能会发生骨水泥外漏压迫、损伤周围脆弱的神经、脊髓、血管组织而被视为临床禁忌。目的:观察骨水泥分期注射在经皮椎体成形治疗中应用的方法和疗效。方法:选择椎体骨皮质不完整的骨质疏松性椎体压缩性骨折患者26例,全部行经皮椎体成形治疗,随机选择12椎体采用骨水泥单侧椎弓根注射,14椎体采用骨水泥双侧椎弓根注射。治疗前后了解骨折椎体复位情况、椎体的容量变化、骨水泥分布及外漏情况及疼痛目测类比评分变化。结果与结论:26个椎体无骨水泥外漏及神经根及脊髓受损情况,无肺栓塞及心脑血管系统急性反应,无手术中死亡。治疗后6个月时,两组椎体体积、疼痛目测类比评分均较治疗前明显改善(P<0.01)。两组间比较差异无显著性意义(P>0.05)。表明采用骨水泥分期注射经扩大了皮椎体成形手术适应证,能有效防止骨水泥外漏,获得满意临床疗效。BACKGROUND： Percutaneous vertebroplasty can induce bone cement leakage to oppress and damage the surrounding nerves, spinal cord and vascular tissues in osteoporotic vertebral compression fractures patients who have incomplete vertebral bone cortex. OBJECTIVE： To observe the method and therapeutic effect of staged injection of bone cement in percutaneous vertebroplasty. METHODS： Twenty-six patients with osteoporotic vertebral compression fractures, who had incomplete vertebral bone cortex, underwent percutaneous vertebroplasty. Of the 26 patients, 12 received unilateral transpedicular injection and 14 were administered with bilateral transpedicular injection of bone cement. The fractured vertebra reduction, vertebral volume, distribution and leakage of bone cement and visual analogue scale scoring were observed before and after operation. RESULTS AND CONCLUSION： Al the operations were successful, with no leakage of bone cement, damage of nerve root or spinal cord, pulmonary embolism, and acute cardiovascular system response. None of patients died during the operation. After 6 months, vertebral volume and scores on visual analogue scale were improved significantly （P 〈 0.01）. However, no difference in the vertebral volume and visual analogue scale scores was found between the two groups （P 〉 0.01）. As described above, staged injection of bone cement increases the surgical indications for percutaneous vertebroplasty, avoid the leakage of bone cement effectively and get satisfactory clinical curative effect.

关 键 词：生物材料 组织工程骨材料 骨水泥 渗漏 经皮椎体成形术 骨质疏松性压缩性骨折 分期注射 适 应证 骨皮质 椎体复位 生物材料图片文章 

分 类 号：R318[医药卫生—生物医学工程]