灌注骨水泥多孔中空椎弓根钉治疗骨质疏松性胸腰椎疾病34例分析  

Analysis of 34 cases of osteoporotic thoracolumbar diseases treated with cement injectable cannulated pedicle screws

作　　者：韩琦 王照卿 韦力 韦善华 韦宝堂 龙振江 HAN Qi;WANG Zhaoqing;WEI Li;WEI Shanhua;WEI Baotang;LONG Zhenjiang(Department of Spinal Surgery,the First People's Hospital of Hechi,Hechi 546300,Guangxi,China)

机构地区：[1]广西河池市第一人民医院脊柱外科,广西河池546300

出　　处：《右江医学》2023年第11期1012-1016,共5页Chinese Youjiang Medical Journal

摘　　要：目的探讨灌注骨水泥中空多孔椎弓根钉治疗骨质疏松性胸腰椎相关疾病的临床疗效。方法回顾性分析34例应用灌注骨水泥多孔椎弓根钉手术治疗胸腰椎骨质疏松患者,采用日本矫形外科协会评分系统对手术效果进行评价,参照BURKUS及SINGH评估椎弓根螺钉稳定性及脊柱融合情况。结果对所有患者随访6~18个月。末次随访时JOA改善率为:显效28例,有效6例;螺钉稳定性评分平均为(2.8±0.2)分,骨融合评分平均为(2.9±0.1)分。术中有3例患者各有一枚螺钉骨水泥渗漏入椎体周围,但未进入椎管,无神经损害表现,2例发生切口脂肪液化,延期愈合;1例发生尿路感染;2例出现腰背部疼痛,需口服镇痛类药物减轻症状,1例出现1枚螺钉断裂。结论骨水泥多孔中空椎弓根钉固定技术能提高骨质疏松性脊柱内固定强度和稳定性,是治疗骨质疏松性胸腰椎相关疾病有效的手术内固定方式。Objective To investigate the clinical efficacy of cement injectable cannulated pedicle screws in the treatment of osteoporotic thoracolumbar related diseases.Methods Retrospective analysis was made on 34 cases of thoracolumbar osteoporotic patients treated with cement injectable cannulated pedicle screws.Surgical effect was evaluated with the scoring system of the Japanese Orthopedic Association,referring to BURKUS and SINGH's evaluation method of pedicle screw stability and spinal fusion.Results All patients were followed up for 6 to 18 months.At the last follow-up,JOA improvement rate was:28 cases were significantly effective,6 cases were effective;average screw stability score was(2.8±0.2)points,and average bone fusion score was(2.9±0.1)points.In 3 cases,each of them had a screw with bone cement leaking into vertebral body,but it did not enter vertebral canal and showed no neurological damage;2 cases had fat liquefaction in incision and delayed healing;1 case had urinary tract infection;2 cases had lumbago and back pain and needed to take analgesics orally to relieve the symptoms,and 1 case had 1 broken screw.Conclusion Cement injectable cannulated pedicle screws can improve the strength and stability of osteoporotic spinal internal fixation,and is an effective method for the treatment of osteoporotic thoracolumbar and lumbar diseases.

关 键 词：多孔中空椎弓根钉 胸腰椎疾病 骨质疏松 骨水泥 

分 类 号：R683.1[医药卫生—骨科学]