骨水泥螺钉结合后外侧融合治疗骨质疏松性胸腰椎压缩骨折  

Treating Osteoporotic thoracolumbar fractures with cement augmented pedicles and posterior-lateral fusion

作　　者：刘涛[1] 张楠 齐艳秋[1] 孙坚皓 葛淼 张力[1] 谭磊[1] LIU Tao;ZHANG Nan;QI Yanqiu;SUN Jianhao;GE Miao;ZHANG Li;TAN Lei(Department of Spinal Surgery,Weifang Hospital of Traditional Chinese Medicine,Weifang 261041,China)

机构地区：[1]潍坊市中医院脊柱外科,山东淮坊261041

出　　处：《潍坊医学院学报》2022年第3期222-224,共3页Acta Academiae Medicinae Weifang

摘　　要：目的观察聚甲基丙烯酸甲酯(PMMA)增强的多孔椎弓根螺钉(简称骨水泥螺钉)结合后外侧融合治疗骨质疏松性胸腰椎压缩骨折的安全性及疗效。方法自2015年5月~2018年5月共收治骨质疏松性胸腰椎压缩骨折患者33例,均应用骨水泥螺钉进行短节段固定,并予以后外侧融合,共使用142枚骨水泥螺钉(其中5例6枚,28例4枚)。临床结果采用视觉模拟评分(VAS)和Oswestry功能障碍指数(ODI)评估。椎体高度维持情况采用椎体前缘压缩率及Cobb角评估。结果所有患者随访至少12个月。术中出现椎间隙渗漏4例,椎旁渗漏3例,未出现明显的椎管内渗漏,术后未出现神经脊髓症状。患者离院、术后6个月、12个月背部疼痛明显较术前缓解,ODI评分较术前改善,术后椎体高度无明显丢失,Cobb角维持好,未发现内固定松动、断裂。结论短节段骨水泥螺钉固定结合后外侧植骨融合治疗骨质疏松性胸腰椎压缩骨折临床效果可靠。Objective To evaluate the effect and safety of polymethylmethacrylate(PMMA)-augmented fenestrated pedicle screws combined posterior-lateral fusion in treating osteoporosis thoracolumbar fractures.Methods Thirty-three patients with osteoporotic thoracolumbar compression fractures were admitted from May 2015 to May 2018,who underwent PMMA-augmented short-segmental pedicle screws fixation and posterior-lateral fusion.One hundred and forty-two pedicles were inserted,5 patients with 6 pedicles and the other 28 patients with 4 pedicles.Clinical outcomes were assessed by visual analogue scale(VAS)and Oswestry disability index(ODI).Vertebral anterior compress ratio and kyphotic Cobb angle were used to assess maintenance of centrum vertebrae height.Results All patients were followed up at least 12 months.There were 4 cases of intervertebral leakage,3 cases of paravertebral PMMA leakage during operation,without obvious intraspinal leakage and neural syndrome.Significant pain relief was achieved with ODI reduced before depart from hospital at 6 months and 12 months after surgery.No significant loss of vertebral height and Cobb angle maintained well after surgery.No loosening or breakage of internal fixation occurred.Conclusion The cement-augmented short-segmental pedicle screw fixation combined with posterior-lateral fusion is effective for osteoporotic thoracolumbar fracture.

关 键 词：骨水泥螺钉 压缩骨折 骨质疏松 后外侧融合 

分 类 号：R687.3[医药卫生—骨科学]