椎体强化术后继发骨水泥渗漏类型及其危险因素的临床评价  

Clinical evaluation of the patterns and risk factors of bone cement leakage and its related risk factors secondary to vertebral augmentation

作　　者：张保良 陈仲强[1] Zhang Baoliang;Chen Zhongqiang(Department of Orthopaedics,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院脊柱外科,100191

出　　处：《中华骨科杂志》2021年第5期330-338,共9页Chinese Journal of Orthopaedics

摘　　要：经皮椎体成形术(percutaneous vertebroplasty,PVP)与经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)是目前公认的治疗骨质疏松性和病理性椎体骨折安全有效的脊柱微创技术,广泛应用于临床。而骨水泥渗漏是其最常见的并发症,可导致邻椎再骨折、肺脑栓塞及截瘫等严重后果。骨水泥可沿不同的路径渗至不同的部位、形成不同的形态、产生不同的临床症状,因此对骨水泥渗漏进行完善的分型对研究其发生率、危险因素及防治措施具有重要的意义。迄今为止,国内外学者提出了多种骨水泥渗漏分型,并阐明了其临床意义,但均存在一定的局限性,尚无统一标准。因此,对各种骨水泥渗漏临床类型及其危险因素进行归纳总结,评价其临床意义,可为进一步探索骨水泥渗漏发生的原因及预防措施提供参考。Percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)are safe and effective minimally invasive spinal techniques for the treatment of osteoporotic and pathological vertebral fractures,which are widely used in clinical practice.Cement leakage is the most common complication,which can lead to serious consequences such as adjacent vertebral refracture,pulmonary or cerebral embolism and paraplegia.Clinically,bone cement can penetrate into different sites along different paths,form different morphologies,and present different clinical symptoms.Therefore,an impeccable classification of bone cement leakage is beneficial to study its incidence,risk factors and prevention and treatment measures.So far,domestic and foreign scholars have proposed a variety of bone cement leakage classifications and elucidated its clinical significance despite certain limitations,but no uniform standard is established.Therefore,this review summarizes various classification and risk factors of cement leakage and evaluates their clinical implications,aiming at providing a reference for further clinical studies.

关 键 词：骨水泥渗漏 经皮椎体成形术 经皮椎体后凸成形术 脑栓塞 骨质疏松性 椎体骨折 脊柱微创 再骨折 

分 类 号：R687.3[医药卫生—骨科学]