椎体后凸成形术治疗骨质疏松性椎体压缩骨折的并发症及预防措施  

The complications and prevent strategies of percutaneous kyphoplasty in treatment of the osteoporotic vertebral compression fracture

作　　者：翟伟峰[1] 贾永伟[1] 王建杰[1] 程黎明[1] 曾至立[1] 于研[1] 陈雷[1] 

机构地区：[1]同济大学附属同济医院脊柱外科,上海200065

出　　处：《中国临床医生杂志》2015年第7期41-44,共4页Chinese Journal For Clinicians

基　　金：上海市卫生局科研项目(编号2009138)

摘　　要：目的研究椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效及常见并发症,探讨并发症发生的原因及应对策略。方法回顾性分析应用椎体后凸成形术治疗的330例胸、腰椎骨折患者(共404节椎体),对其临床疗效及并发症进行观察,分析并发症发生的原因并提出预防措施。结果所有患者均顺利完成手术,发生骨水泥渗漏76节椎体(18.8%),骨折再塌陷12节椎体(3.0%),邻近椎体骨折18例(5.4%),椎弓根内壁破裂3节椎体(0.7%)。所有患者均未出现明显脊髓、神经损伤症状。结论椎体后凸成形术是治疗骨质疏松性椎体压缩骨折的有效方法,但存在骨水泥渗漏、肺栓塞、再骨折、邻近椎体骨折以及神经、脊髓损伤等风险,严格的把握手术指征和提高手术操作水平,可减少并发症的发生。Objective To explore the clinical effect and complications of percutaneous kyphoplasty in treatment of the osteoporotic vertebral compression fracture. Analysis was made of the reasons and prevent strategies for the complications. Method 330 cases（ 404 vertebrae） of osteoporotic vertebral compression fractures from July 2007 to December 2013 treated with percutaneous kyphoplasty were retrospectively reviewed. To observe the clinical effect and complications,to find out the reasons and prevent strategies for the complications. Result 330 cases（ 404 vertebrae）were admitted. Seventy-six vertebrae showed cement leaking out of the vertebrae（ 18. 8%）,twelve vertebrae showed vertebral body collapse（ 3. 0%）,eighteen cases were found new osteoporotic vertebral compression fracture（ 5. 4%）and three vertebrae suffered from bursting of pedicle inside wall（ 0. 7%）. No cases with serious spinal nerve injury were found. Conclusion Percutaneous kyphoplasty is effective in treatment of the osteoporotic vertebral compression fracture. However,the operating risk is high,we should be aware of the complications like pulmonary embolism,the leakage of bone cement,new fracture,spinal nerve damage and Infections. Strict pre-operation plan,normalized treatment after operation and improving operation skill are the most important preventive strategies.

关 键 词：椎体后凸成形术 并发症 预防措施 

分 类 号：R687[医药卫生—骨科学]