经皮穿刺加压植入骨棒骨粉椎体成形治疗胸腰椎体压缩性骨折:恢复伤椎结构完整性和稳定性  

Percutaneous vertebroplasty combined with granulated allogeneic bone grafting for thoracolumbar compressive fractures: the completeness and stability of fractured vertebrae

作　　者：林玉江[1] 杨利民[1] 杨健[1] 

机构地区：[1]青岛市市立医院东院脊柱外科,山东省青岛市266011

出　　处：《中国组织工程研究》2017年第23期3670-3675,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:经皮穿刺椎体成形目前主要被应用于老年骨质疏松性压缩骨折的患者,而对于中青年椎体压缩骨折的患者,主要应用椎弓根螺钉内固定技术,但其存在创伤大、断钉、二次手术等问题。目的:观察经皮穿刺骨粉加压植入椎体成形修复胸腰椎体压缩性骨折的临床效果。方法:选取21例胸腰椎压缩性骨折患者,行经皮穿刺骨粉加压植入椎体成形,术前计算需植骨量,统计手术时间及出血量,观察患者治疗前后的疼痛程度、以及治疗前、后椎体高度比及Cobb角情况。结果与结论:(1)与治疗前比较,治疗后1 d及治疗后6个月疼痛目测类比评分显著降低(P<0.05);(2)与治疗前比较,治疗后1 d及治疗后6个月伤椎前缘高度比显著增大(P<0.05);(3)与治疗前比较,治疗后1 d及治疗后6个月椎体Cobb角度显著减小(P<0.05);(4)手术时间平均为(52.0±12.3)min,术中出血量平均为(11.5±1.5)m L;(5)结果说明,经皮穿刺骨粉加压植入椎体成形可以有效地恢复伤椎前缘高度,消除伤椎内的空腔,恢复伤椎的结构完整性和稳定性;最大程度的保留脊柱的运动功能,是一种治疗胸腰段椎体骨折的有效的微创手术方法。Percutaneous vertebroplasty combined with granulated allogeneic bone grafting for thoracolumbar compressive fractures： the completeness and stability of fractured vertebraeBACKGROUND： Percutaneous vertebroplasty is mainly used to treat senile osteoporotic compressive fractures, while for young patients, pedicle screw internal fixation is usually applied, but heavy trauma, nail broken, secondary surgery and other problems can be found occasionally. OBJECTIVE： To investigate the clinical efficacy of percutaneous vertebroplasty combined with granulated allogeneic bone grafting for thoracolumbar compressive fractures. METHODS： Twenty-one patients suffering thoracolumbar compressive fractures were recruited, and underwent percutaneous vertebroplasty combined with granulated allogeneic bone grafting. The Visual Analogue Scale scores, height ratio of fractured vertebrae and Cobb angle were detected before and after surgery. RESULTS AND CONCLUSION： （1） Compared with baseline, the Visual Analogue Scale scores were improved significantly at 1 day and 6 months postoperatively （P 〈 0.05）. （2） The height ratio of fractured vertebrae at 1 day and 6 months postoperatively was significantly higher than that before treatment （P 〈 0.05）. （3） The Cobb angle of fractured vertebrae at 1 day and 6 months postoperatively was significantly less than that before treatment （P 〈 0.05）. （4） The mean operation time was （52±12.3） minutes, and the mean blood loss was （11.5＋1.5） mL. （5） These results suggest that percutaneous vertebroplasty combined with granulated allogeneic bone grafting can effectively restore the anterior fractured vertebral height, eliminate the cavity in the fractured vertebrae, renew the completeness and stabilization of the fractured vertebrae, which keep the spinal range of motion; therefore, it is a minimal invasive method in the treatment of thoracolumbar fractures.

关 键 词：骨科植入物 脊柱植入物 胸腰椎医缩性骨折 经皮穿刺 骨粉加医植骨 椎体减形术 微创 

分 类 号：R318[医药卫生—生物医学工程]