骨水泥注入中空侧孔椎弓根钉内固定治疗伴有骨质疏松症的腰椎滑脱  

Treatment of lumbaRspondylolisthesis with osteoporosis by internal fixation of hollow lateral hole pedicle screw with bone cement injection

作　　者：杨俊[1] 赵敏[1] 周江军[1] 史柏娜[1] 刘达 YANG Jun;ZHAO Min;ZHOU Jiang-jun;SHI Bai-na;LIU Da(Dept of Orthopaedics,the 908th Hospital of Joint Logistic Support Force of CPLA,Yingtan,Jiangxi 335000,China)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院骨科,江西鹰潭335000 [2]西部战区总医院骨科,四川成都610083

出　　处：《临床骨科杂志》2022年第2期189-192,共4页Journal of Clinical Orthopaedics

基　　金：全军医学科技青年培育项目(编号:13QNP049);“十二五”全军后勤科研计划重点项目(编号:BNJ13J003);江西省鹰潭市科技局成果推广计划(编号:YKS20210068)。

摘　　要：目的探讨骨水泥注入中空侧孔椎弓根钉内固定治疗伴有骨质疏松症的腰椎滑脱的临床疗效。方法采用骨水泥注入中空侧孔椎弓根钉内固定治疗15例伴有骨质疏松症的腰椎滑脱患者。记录手术时间、术中出血量、住院时间、骨水泥注入量、并发症发生情况、植骨融合情况。比较手术前后腰椎骨密度、疼痛VAS评分。结果患者均获得随访,时间13~36(19.8±6.3)个月。手术时间105~170(140.6±17.3)min,术中出血量170~800(410.0±133.3)ml,住院时间9~21(15.0±2.8)d;每个中空椎弓根钉内注入骨水泥1~2(1.5±0.3)ml。术后X线片显示滑脱椎体均复位。术中3例发生椎旁骨水泥渗漏;术后均未发生神经、血管损伤等并发症。术后1年疼痛VAS评分、腰椎骨密度均明显优于术前(P<0.05)。末次随访时,腰椎X线片显示椎弓根钉无松动、移位、断裂,椎弓根钉周围未见透亮线,均达植骨融合。结论骨水泥注入中空侧孔椎弓根钉内固定治疗伴有骨质疏松症的腰椎滑脱疗效可靠。Objective To investigate the clinical effect of hollow lateral hole pedicle screw with bone cement injection internal fixation foRtreatment of lumbaRspondylolisthesis with osteoporosis.Methods The 15 patients with lumbaRspondylolisthesis with osteoporosis were treated by hollow lateral hole pedicle screw with bone cement injection internal fixation.The duration of operation,intraoperative blood loss,length of hospital stay,injection volume of bone cement,incidence of complications,and fusion situation of bone grafts were recorded.LumbaRbone mineral density and pain VAS were compared before and afteRsurgery.Results All patients were followed up foR13~36(19.8±6.3)months.The operation time was 105~170(140.6±17.3)min.Intraoperative blood loss was 170~800(410.0±133.3)ml;the length of hospital stay was 9~21(15.0±2.8)d;1~2(1.5±0.3)ml of human bone cement was injected into each hollow lateral hole pedicle.Postoperative radiographs showed that all the slippage vertebrae were reduced.Paravertebral bone cement leakage occurred in 3 cases during the operation,and no postoperative complications such as nerve injury and vasculaRinjury occurred.Pain VAS and lumbaRbone density at 1 yeaRwere significantly betteRthan those before operation(P<0.05).At the last follow-up,the X-ray film of lumbaRspine showed no loosening,displacement oRfracture of the pedicle screws,and no cleaRlines around the pedicle screws,all of which reached bone graft fusion.Conclusions The hollow lateral hole pedicle screw with bone cement injection internal fixation is effective in treating lumbaRspondylolisthesis with osteoporosis.

关 键 词：中空侧孔椎弓根钉 骨质疏松 腰椎滑脱 骨水泥 

分 类 号：R681.53[医药卫生—骨科学] R687.3[医药卫生—外科学]