填充明胶海绵碎粒在经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折中的应用  

The application of filling gelatin sponge debris in the percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures

作　　者：刘上楼[1] 刘勇[1] 张云庆[1] 邓雄伟[1] 方剑锋[1] LIU Shang-lou;LIU Yong;ZHANG Yun-qing;DENG Xiong-wei;FANG Jian-feng(Dept of Orthopaedics,the People′s Hospital of Jiangyin City,Jiangyin,Jiangsu 214400,China)

机构地区：[1]江阴市人民医院骨科,江苏江阴214400

出　　处：《临床骨科杂志》2021年第6期773-776,共4页Journal of Clinical Orthopaedics

基　　金：国家卫计委医药卫生科技发展研究中心项目(编号:W2012ZT10)。

摘　　要：目的探讨填充明胶海绵碎粒在经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)中的应用效果,以及对降低骨水泥渗漏率的作用。方法采用PKP治疗80例OVCF患者,根据术中是否填充明胶海绵碎粒将患者分为明胶海绵组(PKP术中灌注骨水泥前填充明胶海绵碎粒治疗,40例)和对照组(PKP术中常规灌注骨水泥治疗,40例)。记录两组手术情况,比较两组疼痛VAS评分、伤椎前缘压缩程度、伤椎Cobb角。结果手术时间、骨水泥注入量明胶海绵组长(多)于对照组(P<0.05)。住院时间两组比较差异无统计学意义(P>0.05)。患者均获得随访,时间1~3个月。VAS评分、伤椎前缘压缩程度、Cobb角两组术后均明显优于术前(P<0.05);术后两组间比较差异均无统计学意义(P>0.05)。明胶海绵组未发生骨水泥渗漏,对照组6例(15%)发生骨水泥渗漏,两组骨水泥渗漏率比较差异有统计学意义(P<0.05)。结论PKP治疗OVCF术中灌注骨水泥前填充明胶海绵碎粒可有效减少骨水泥渗漏的发生,且经济方便,术后效果良好。Objective To investigate the application effect of filling gelatin sponge debris in the percutaneous kyphoplasty(PKP)for treatment of osteoporotic vertebral compression fracture(OVCF),and the role of reducing the leakage reate of the bone cenement.Methods The 80 elderly patients with OVCFs were treated with PKP,of which 40 cases were filled with gelatin sponge debris before bone cement injection(gelatin sponge group),the other 40 patients were performed with the conventional bone cement injection(control group).The surgery sitaution,visual analogue scale(VAS)of pain,the compression degree of anterior edge of the injured vertebrae,and Cobb angle of the injured vertebrae were compared between two groups.Results The operation time and the volume of bone cement injection in the gelatin sponge group were longer(more)than those in the control group(P<0.05),and there was no significant difference in the hospitalization time between the two groups(P>0.05).All patients were followed up for 1~3 months.The VAS,compression degree of the injured vertebral anterior edge,Cobb angle in the postoperation were significantly better than those in the preoperation(P<0.05);there were no differences in the postoperative indicators between the two groups(P>0.05).The bone cement leakage situation:no one case occurred in the gelatin sponge group,and control group had 6 cases(15%),there was statistical difference in leakage rate of bone cement between two groups(P<0.05).Conclusions Filling gelatin sponge debris can effectively reduce bone cement leakage in PKP for treatment of OVCFs,and it′s economical and convenient,with good postoperative effect.

关 键 词：体位过伸复位 明胶海绵碎粒 骨水泥 椎体后凸成形术 骨质疏松性椎体压缩骨折 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]