PKP治疗骨质疏松性爆裂骨折疗效及骨水泥渗漏途径的探讨  

Efficacy of percutaneous kyphoplasty for treating osteoporotic burst fractures and bone cement leaking pathway

作　　者：王永江[1] 王清 姚琦[3] 

机构地区：[1]内蒙古自治区鄂尔多斯市中心医院脊柱外科,内蒙古鄂尔多斯017000 [2]泸州医学附属医院脊柱外科,四川泸州646000 [3]北京世纪坛医院骨科,北京100038

出　　处：《重庆医学》2015年第11期1457-1459,1462,共4页Chongqing medicine

基　　金：国家自然科学基金资助项目(81000796)

摘　　要：目的通过经皮椎体后凸成形术(PKP)治疗骨质疏松性爆裂骨折(OVBF),评估临床疗效及探寻骨水泥向椎管内渗漏的途径。方法根据AO分型,将2005年10月至2013年5月鄂尔多斯市中心医院收治的OVBF患者45例(45个椎体),采用PKP治疗,通过术后CT平扫确定骨水泥向椎管内、椎间隙渗漏的途径,测量术前、术后椎体高度、Cobb角、椎管狭窄改善情况。比较术前、术后视觉模拟评分(VAS)变化情况。结果骨水泥向椎管内渗漏2例,渗漏途径主要是通过椎基静脉孔,骨水泥向上位椎间隙渗漏高于下位椎间隙。椎体高度恢复、Cobb矫正、VAS术前、术后比较,差异有统计学意义(P<0.05)。椎管狭窄率术前、术后比较,差异无统计学意义(P>0.05)。结论 PKP治疗OVBF不是禁忌证,OVBF经PKP治疗后骨水泥向椎管内渗漏主要途径是椎基静脉孔,向椎间隙渗漏与终板损伤有关。Objective To evaluate the clinical curative efficacy and to explore the leaking pathway of bone cement to verte‐bral canal through treating osteoporotic vertebral burst fractures （OVBF） by using percutaneous kyphoplasty（PKP） .Methods Ac‐cording to AO classification ,45 OVBF patients with 45 vertebras in the Erdos Central Hospital from October 2005 to May 2013 were treated by using PKP .The pathway of bone cement leaking to spinal canal and intervertebral space was determined by postop‐erative CT plain scan .The postoperative vertebral height ,Cobb angle and spinal stenosis improvement were measured .The change of VAS were compared between before and after operation .Results There were 2 cases of bone cement leaking to spinal canal .The leaking passway was mainly through basivertebral foramen .The leakage of bone cement to superior intervertebral space was higher than that to lower intervertebral space .The recovery of the vertebral height ,correction of Cobb angle and pre‐and post‐operative VAS scores had statistically significant differences （P〈0 .05） .The spinal stenosis rate had no statistical difference between before and after operation（P〉0 .05） .Conclusion PKP for treating OVBF is not a contraindication .The main pathway of bone cement lea‐king to spinal canal is basivertebral foramen after the treatment of OVBF by using PKP ,the leakage to intervertebral space is relat‐ed with the endplate damage .

关 键 词：椎体成形术 骨质疏松 爆裂骨折 骨水泥渗漏 椎基静脉孔 

分 类 号：R687.3[医药卫生—骨科学]