骨填充网袋治疗老年性骨质疏松性椎体压缩骨折的特点  

Characteristics of bone filling mesh container for treating osteoporotic vertebral compression fractures in older adults

作　　者：黄浩然[1,2] 冯丽 梁华 冯德伟[5] 滕学仁 于桦[6] Huang Hao-ran;Feng Li;Liang Hua;Feng De-wei;Teng Xue-ren;Yu Hua(School of Graduate,Taishan Medical University,Taian 271000,Shandong Province,China;Department of Spine and Joint Surgery,Chengyang District People’s Hospital,Qingdao 266000,Shandong Province,China;Department of Joints and Sports Medicine,6Central Operative Room,East Branch,Qingdao Municipal Hospital,Qingdao 266000,Shandong Province,China;Third Department of Internal Medicine,Qingdao Tumor Hospital,Second Affiliated Hospital of Qingdao University Medical School,Qingdao 266000,Shandong Province,China;Affiliated Hospital of Guizhou Medical University,Guiyang 550000,Guizhou Province,China)

机构地区：[1]泰山医学院研究生部,山东省泰安市271000 [2]青岛市城阳区人民医院脊柱与关节外科,山东省青岛市266000 [3]青岛市市立医院东院区骨关节与运动医学科,山东省青岛市266000 [4]青岛大学医学院第二附属医院青岛肿瘤医院肿瘤内三科,山东省青岛市266000 [5]贵州医科大学附属医院,贵州省贵阳市550000 [6]青岛市市立医院东院区中心手术室,山东省青岛市266000

出　　处：《中国组织工程研究》2018年第26期4110-4115,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:应用骨填充网袋治疗椎体压缩骨折,不仅可有效恢复椎体的高度及生物力学功能,还可明显减少骨水泥渗漏,提高手术的成功率,是当前组织工程学研究及治疗椎体压缩性骨折的热点。目的:评价骨填充网袋治疗老年椎体压缩骨折的临床效果。方法:前瞻性分析30例老年性骨质疏松性椎体压缩骨折患者的临床资料,年龄56-78岁,所有患者均为单一节段椎体压缩骨折,均采取双侧经皮椎体后凸成形技术置入骨填充网袋,随后向其内注射骨水泥。治疗后1 d、1周、1个月、6个月,检测患者目测类比评分、椎体中部及前缘椎体抬升百分比、后凸畸形Cobb's角及Oswestry功能障碍指数评分。结果与结论:30例患者均顺利完成手术,无骨水泥渗漏。患者治疗后1 d、1周、1个月、6个月的目测类比评分明显低于治疗前(P<0.05),治疗后1 d、1周、1个月、6个月的Oswestry功能障碍指数评分明显低于治疗前(P<0.05),治疗后1 d、1周、1个月、6个月的后凸畸形Cobb’s角明显低于治疗前(P<0.05),治疗后不同时间点的椎体中部及前缘椎体抬升百分比无差异。结果表明对于老年性骨质疏松性椎体压缩骨折的治疗,骨填充网袋可明显改善患者的疼痛、椎体高度及后凸畸形,显著减少椎体骨水泥外渗。BACKGROUND： A bone filling mesh container in the treatment of vertebral compression fractures can not only effectively restore vertebral body height and biomechanical function, but also obviously reduce the leakage of bone cement and improve the success rate of surgery. Therefore, this method has aroused great attention in the current tissue engineering research and in the treatment of vertebral compression fractures. OBJECTIVE： To evaluate the clinical effect of bone filling mesh container in the treatment of osteoporotic vertebral compression fractures in the older adults. METHODS： Thirty cases of senile osteoporotic vertebral compression fractures were prospectively analyzed. Patients aged 56-78 years presented with single segmental vertebral compression fractures and underwent bilateral percutaneous kyphoplasty with the implantation of bone filling mesh container followed by bone cement injection. We detected visual analogue scale score, percentage of the elevation of the middle and anterior vertebral bodies, posterior Cobb’s angle and Oswestry dysfunction index score at postoperative 1 day, 1 week, 1 month and 6 months, respectively. RESULTS AND CONCLUSION： All 30 patients completed the operation without bone cement leakage. After treatment, the visual analogue scale score, posterior Cobb’s angle and Oswestry dysfunction index score were significantly lowered in all patients （P 〈 0.05）. However, there was no difference in the percentage of the elevation of the middle and anterior vertebral bodies at different time points after treatment. To conclude, the use of bone filling mesh container can obviously relieve patient’s pain, improve vertebral body height and protrusion deformity,and meanwhile significantly reduce bone cement leakage in patients with senile osteoporotic vertebral compression fractures.

关 键 词：经皮椎体后凸成形术 球囊 椎体压缩性骨折 骨填充网袋 骨水泥 生物材料 

分 类 号：R318[医药卫生—生物医学工程]