经皮椎体强化治疗骨质疏松性椎体压缩性骨折:导航定位、骨折复位系统、骨水泥渗漏及材料的改良  

Percutaneous vertebral augmentation for osteoporotic vertebral compression fractures: navigation, fracture reduction system, bone cement leakage, and material modification

作　　者：王智强 林路 陈萧霖[2] 柯珍勇[2] Wang Zhiqiang;Lin Lu;Chen Xiaolin;Ke Zhenyong(Chongqing Medical University,Chongqing 400000,China;Department of Orthopedics of The Second Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]重庆医科大学,重庆市400000 [2]重庆医科大学附属第二医院骨科,重庆市400000

出　　处：《中国组织工程研究》2022年第4期631-636,共6页Chinese Journal of Tissue Engineering Research

摘　　要：背景:经皮椎体强化是治疗骨质疏松性椎体压缩性骨折的重要治疗方式,但随着临床实践的深入其存在的局限性逐渐显露,众多研究者对其进行了研究改良。目的:拟从导航定位及手术入路方式、骨折复位系统及防骨水泥渗漏技术、骨水泥材料等成分方面阐述经皮椎体强化术的改良与研究进展。方法:应用计算机检索PubMed、Embase、CNKI、万方及维普数据库2000年1月到2020年4月的相关文章,中文检索词为"骨质疏松性椎体压缩性骨折,经皮椎体强化术,经皮椎体成形术,经皮椎体后凸成形术",英文检索词为"osteoporotic vertebral compression fracture,percutaneous vertebral augmentation,percutaneous vertebroplasty,percutaneous kyphoplasty"。查阅相关文章,最终共纳入61篇文献进行归纳总结。结果与结论:(1)O-arm导航及3D打印技术对于上胸椎压缩性骨折、严重椎体压缩性骨折、合并脊柱侧弯等手术难度大的患者很有帮助;(2)目前多数观点认为单侧入路较双侧更具有优势,但仍需进一步的研究;(3)目前存在多种骨折复位系统及防骨水泥渗漏技术,不同的结构特点使其在治疗上各有优势,需根据不同的情况具体选择;(4)磷酸钙骨水泥具有巨大的潜力,未来可能会逐步替代传统骨水泥材料。BACKGROUND: Percutaneous vertebroplasty is an important treatment for osteoporotic vertebral compression fractures. With the development of clinical practice, its limitations gradually revealed. Many researchers have studied and improved it.OBJECTIVE: To summarize the latest research progress on the navigation and surgical approach, fracture reduction system, prevention of cement leakage, and bone cement materials. METHODS: The computer was used to search relevant articles from Pub Med, Embase, CNKI, Wanfang, and VIP databases from January 2000 to April 2020. The Chinese and English terms were "osteoporotic vertebral compression fracture, percutaneous vertebral augmentation, percutaneous vertebroplasty, percutaneous kyphoplasty". After consulting the relevant articles, 61 articles were included to analyze the results.RESULTS AND CONCLUSION:(1) O-arm navigation and 3 D printing technology are very helpful for patients with upper thoracic vertebral compression fracture, severe vertebral compression fracture, and compression fracture with scoliosis.(2) Most opinions think that unilateral approach is more advantageous than bilateral approach, but further research is still necessary.(3) There are many fracture reduction systems and technologies of preventing cement leakage. Different structural characteristics make them have their own advantages, which one should be chosen to treat patients depends on different conditions.(4) Calcium phosphate cement has great potential and may gradually replace traditional bone cement materials in the future.

关 键 词：骨 材料 骨质疏松 椎体骨折 经皮椎体强化 骨折复位 穿刺定位 骨水泥渗漏 骨水泥 综述 

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