96例(112椎)经皮球囊扩张椎体后凸成形术临床疗效及并发症观察  

Clinical Observation on the Efficacy and complications of Percutaneous Kyphosis Plasty among 96 Patients (112 vertebral)

作　　者：叶桂峰[1] 王耀宗[1] 马军[1] 陈辉东[1] 杨镔[1] 

机构地区：[1]厦门大学附属中山医院创伤骨科,福建厦门361004

出　　处：《生物骨科材料与临床研究》2013年第5期41-44,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的探讨经皮球囊扩张椎体后凸成形术的临床疗效及并发症。方法自2009年5月～2012年8月共有96例112椎的椎体压缩性骨折行椎体成形术，术前充分准备、评估，术前x线检查椎体在40％以内，CT检查提示椎体后缘完整，椎管内无明显狭窄，术中采用局部浸润麻醉，C臂下确认病椎与监视骨水泥在椎体内弥散情况，病椎中注入骨水泥。结果96例全部获得随访，随访时间12月（1-17月），术后临床疗效按视觉模拟评分法疼痛评分：0分：58例，0-3分（不包括0分）：35例，4-6分：3例，无症状的骨水泥漏20椎，相邻椎体骨折5例，病椎再骨折1例，无骨水泥反应与有症状的肺栓塞病例发生。结论经皮球囊扩张椎体后凸成形术作为一种安全有效治疗老年椎体骨折的方法，术前选择合适病例，严格手术指征，能获得满意的临床效果，但仍有相当比例病例出现骨水泥渗漏，虽无明显临床症状，仍应引起足够的重视与尽量避免。Objective To investigate the clinical efficacy and complications of percutaneous kyphosis plasty. Methods From May 2009 to August 2012, total of 96 patients with 112 vertebral compression fractures were done with vertebro plasty, full preoperative preparation, evaluation, X-ray examination of the vertebral body compressed in less than 40%, CT scan shows the the posterior edge of vertebra did not damaged, spinal cord was not oppressed. Local anesthesia was used, the C arm X ray monitoring bone cement diffuse in the vertebral body in the operation process. Results 96 cases were followed up for 12months （1-17months）, recent clinical efficacy was measured by visual analogue scale： 0 points： 58 cases, 〈3 （except 0）： 35 cases, 4-6：3 cases, 20 cases ofasymptomatic vertebral bone cement leakage, adjacent vertebral fractures occurred in 5 patients, vertebral refracture in 1 patient, none was found bone cemented reaction and pulmonary embolism. Conclusion Percutaneous kyphosis plasty is a safe and effective method to treat vertebral fractures with aged person, well selected the cases for the surgery before operatiion, satisfactory clinical results can be obtained. But there is still a considerable proportion of cases were found leakage of bone cement with no obvious clinical symptoms, it should attract enough attention.

关 键 词：经皮球囊扩张椎体后凸成形术 临床疗效 并发症 骨水泥漏 

分 类 号：R687.3[医药卫生—骨科学]