骨填充网袋椎体成形术治疗周壁破损型胸腰椎压缩性骨折预后不良分析  

Poor outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence

作　　者：井万里[1] 张涛[1] 滕东辉[1] 石涛 周强[1] Jing Wanli;Zhang Tao;Teng Donghui;Shi Tao;Zhou Qiang(Department of Orthopedics,Tianjin First Central Hospital,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院骨科,天津市300192

出　　处：《中国组织工程研究》2021年第10期1522-1527,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:骨填充网袋椎体成形术能有效纠正椎体后凸畸形,恢复椎体高度,还可有效降低骨水泥渗漏率,但骨填充网袋椎体成形术在周壁破损型胸腰椎压缩性骨折中应用的不良预后报道较少。目的:探讨骨填充网袋椎体成形术治疗周壁破损型胸腰椎压缩性骨折的不良预后。方法:选择2017年4月至2018年10月天津市第一中心医院收治的周壁破损型胸腰椎压缩性骨折患者19例,其中男3例,女16例,年龄60-86岁,均接受骨填充网袋椎体成形术治疗。术后随访统计并发症发生情况,评估目测类比评分与Oswestry功能障碍指数,拍摄X射线片测量伤椎椎体高度与伤椎Cobb角。试验获得天津市第一中心医院临床科研项目伦理委员会批准(审查编号:2018N150KY)。结果与结论:①19例患者术后获得9-20个月随访,无术中死亡及术后死亡病例,无肺栓塞、骨水泥过敏、感染等严重并发症的发生,其中7例出现预后不良,包括骨水泥渗漏5例、中度以上疼痛4例、邻近椎体骨折2例;②19例患者末次随访时的目测类比评分、Oswestry功能障碍指数、伤椎椎体高度、伤椎Cobb角均较术前明显改善(P <0.05);③结果表明,骨填充网袋椎体成形术治疗周壁破损型胸腰椎压缩性骨折的预后不良包括:骨水泥渗漏、邻近椎体骨折、术后疼痛等,要严格按照相关操作规范进行手术,做好相关的处理和预防对策,最大限度减少术后不良反应的发生。BACKGROUND: Bone filling mesh container vertebroplasty can effectively correct the kyphotic deformity of the vertebral body, restore the height of the vertebral body, and effectively reduce the rate of bone cement leakage. However, there are few reports on the poor prognosis of bone filling mesh container vertebroplasty in thoracolumbar compression fractures with vertebral body wall incompetence. OBJECTIVE: To discuss adverse outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with vertebral body wall incompetence.METHODS: Totally 19 cases with osteoporotic vertebral compression fracture with vertebral body wall incompetence, who were treated in the Tianjin First Central Hospital from April 2017 to October 2018, were enrolled in this study, including 3 males and 16 females, at the age of 60-86 years. The patients underwent bone filling mesh container vertebroplasty. Postoperative complications were recorded during follow up. Visual analogue scale score and Oswestry disability index were assessed. X-ray films were taken to measure the height of injured vertebral body and Cobb’s angle. This study was approved by the Ethics Committee of Clinical Research Project of Tianjin First Central Hospital(approval No. 2018 N150 KY). RESULTS AND CONCLUSION:(1) All 19 patients were follow-up for 9-20 months. No death occurred during and after operation, and no severe complications such as pulmonary embolism, bone cement allergy or infection occurred. Among them, seven cases had poor prognosis, including five cases of bone cement leakage, four cases of above moderate pain and two cases of adjacent vertebral fractures.(2) Visual analogue scale score, Oswestry disability index, height of injured vertebral body and Cobb’s angle were significantly improved during the final follow-up in 19 patients(P < 0.05).(3) Results showed that poor outcomes of bone filling mesh container vertebroplasty for the treatment of osteoporotic vertebral compression fractures with v

关 键 词：材料 骨 骨水泥 骨质疏松 骨折 经皮椎体成形术 经皮椎体后凸成形术 骨填充网袋 邻近椎体骨折 骨水泥渗漏 

分 类 号：R459.9[医药卫生—治疗学] R318.08[医药卫生—临床医学]