椎体成形术的临床应用  

Clinical application of the percutaneous vertebroplasty

作　　者：田云虎[1] 刘亚[1] 管春和[1] 

机构地区：[1]山东省潍坊医学院附属医院,261031

出　　处：《实用骨科杂志》2003年第2期109-112,共4页Journal of Practical Orthopaedics

摘　　要：目的 :探讨椎体成形术治疗骨质疏松椎体压缩性骨折、椎体肿瘤的早期临床效果。方法 :对 18例骨质疏松椎体压缩性骨折病人的 2 0个椎体以及 5例椎体肿瘤 6个椎体 ,经皮、椎弓根向椎体内穿针并注入聚甲基丙烯酸甲酯(PMMA)。 14例新鲜骨折病人卧床复位满意后再注射。结果 :2 3例病人平均每个椎体注入骨水泥 6 .5 m L ,X线检查骨水泥充满良好 ,骨折复位满意。术后 12 h～ 3d疼痛明显减轻或消失 ,应用视觉模拟评分法测试 ,18例骨质疏松症病人中 14例完全缓解 (0～ 2 ) ,4例中度缓解 (2～ 4分 ) ,疼痛缓解 81%。 14例新鲜骨折病人术后恢复丢失高度的 78%。5例椎体肿瘤中 2例完全缓解 (2～ 4分 ) ,疼痛缓解 81%。 14例新鲜骨折病人术后恢复丢失高度的 78%。 5例椎体肿瘤中 2例完全缓解 (0～ 2分 ) ,3例中度缓解 (2～ 4分 ) ,疼痛缓解 70 %。术中术后无明显并发症出现。对 18例病人(其中肿瘤病人 3人 )随访 8～ 10个月 ,治疗部位疼痛未明显加重 ,椎体形态未有改变。结论 :椎体成形术治疗骨质疏松椎体压缩性骨折及椎体肿瘤 ,能够迅速缓解疼痛 ,增加椎体的强度和脊柱的稳定性 ,是安全有效的微创技术。Objective:To explore the effect of the percutaneous vertebroplasty for osteoporotic vertebral body compression fracturs and vertebral neoplasms.Methods:18 patients with 20 painful vertebral body fractures and 5 patiants with 6 vertebral neoplasms were injected polymethylmethacrylate(PMMA) into the vertebral bodies through the spedicular.There were 7 male and 16 female,the ages were ranged from 48～72 years.All patients had svere back pain.18 patients had Ⅰ～Ⅱ degree vertebral body fractures.14 among 18 patientes were fresh fracrures.5 patients with 6 vertebrea had metastatic neoplasms.All patients did not have nerve roots and spinal cord diseases.Result:All patients pain were relieed immediately at 12 hour to 3 day after treatment,with an average injection amount of 6.5 mL polymethylmethacrylate.Among the 18 patients treated for osteoporotic fratures,14 had complete pain relief,4 moderate relief.14 fresh fracture patients had restored 80% of lost height.2 of 5 patients with maligancies had complete relief,3 had moderate relief.Using visual analogue scales test,the pain reduced approximately 81% and 70%.No complications occurred in the operation or after operation 18 patients were followed up 8～10 months the pian disappeared and vertebral body did not deform.Conclusion:Percutaneous wertebroplasty is a minimaly invasive therapy in the treatment of osteoporotic vertebral commpressive fractures and vertebral neoplasms.It can provide acute pain relief spinal stabilizition in apropriat patients.

关 键 词：椎体成形术 临床应用 骨质疏松 椎体压缩性骨折 椎体肿瘤 X线 骨水泥 复位 

分 类 号：R687[医药卫生—骨科学] R683[医药卫生—外科学]