椎体成形术中骨水泥渗漏分析及防治策略  

Analysis of the incidence and prevention strategies of bone cement leakage after percutaneous vertebroplasty

作　　者：曾希银[1] 聂海[2] 王璨[1] 王永强[1] 张勇[1] 

机构地区：[1]四川省遂宁市第一人民医院骨科,四川遂宁629000 [2]成都大学附属医院骨科,四川成都610081

出　　处：《中国现代医生》2015年第36期62-65,共4页China Modern Doctor

摘　　要：目的 探讨胸腰椎骨折椎体成形术后患者骨水泥渗漏的发生率及预防措施。方法 2009年5月-2015年2月共行经皮椎体成形术356例（413节椎体）,均为骨质疏松性椎体压缩性骨折。观察骨水泥渗漏及渗漏相关并发症。结果 本研究出现骨水泥渗漏139节椎体,其中渗漏至椎管内23节（5.57%）、椎体周缘（包括前缘以及椎体旁）66节（15.98%）、椎间隙内36节（8.72%）、针道内8节（1.94%）、椎间静脉血管渗漏5节（1.21%）、神经根管内1节（0.24%）。所有患者术后疼痛明显缓解,其中2例渗漏入椎管的患者通过减压症状得以缓解,其他患者均无明显的神经症状。结论 椎体成形术有较高的骨水泥渗漏率,骨水泥渗漏的并发症与合理掌握手术适应证、提高穿刺水平、掌握手术操作技巧密切相关。Objective To explore the incidence and prevention strategies of bone cement leakage in patients who had thoracolumbar fractures and received percutaneous vertebroplasty（PVP or PKP）.Methods A total of 356 patients,who had 413 thoracolumhar osteoporotic compression fratures and received PVP or PKP from May 2009 to February2015,were enrolled.The complications of bone cement leakage were observed.Results Statistics showed that 139 vertebrae had bone cement leakage.Twenty-three vertebrae（5.57%） had bone cement leakage into the spinal canal.Sixtysix vertebrae（15.98%） had bone cement leakage into the vertebral margins（front edges and side edges）.Thirty-six（8.72%） had bone cement leakage into the intervertebral space.Eight vertebrae（1.94%） had bone cement leakage into the needle channel.Five vertebrae（1.21%） had bone cement leakage into the intervertebral vein.One vertebra（0.24%）had bone cement leakage into the pedicle tube.All patients had obvious pain relief after the operation.In patients with bone cement leakage,two patients with bone cement leakage into the pedicle tube had nerve compression symptoms,which was relieved by decompression.Other patients had no obvious nerve compression symptoms.Conclusion The incidence of bone cement leakage after PVP or PKP is pretty high.Bone cement leakage is closely related to choosing the suitable cases,improving injecting skill and mastering operation skills.

关 键 词：经皮椎体成形术 骨水泥 渗漏 骨质疏松性椎体压缩性骨折 防治策略 

分 类 号：R681[医药卫生—骨科学]