中国组织工程研究 ›› 2016, Vol. 20 ›› Issue (4): 539-543.doi: 10.3969/j.issn.2095-4344.2016.04.015

• 脊柱植入物 spinal implant • 上一篇    下一篇

经皮椎体后凸与经皮椎体成形术修复骨质疏松椎体压缩性骨折:随机分组比较

谭 斌,刘雄文,刘 刚,黎永生,秦忠军,杨春鹏   

  1. 广西脑科医院骨科,广西壮族自治区柳州市 545005
  • 收稿日期:2015-10-26 出版日期:2016-01-22 发布日期:2016-01-22
  • 作者简介:谭斌,男,1977年生,广西壮族自治区象州县人,汉族,2001年广西医科大学毕业,主治医师,主要从事脊柱关节研究。

Percutaneous kyphoplasty versus percutaneous vertebroplasty for osteoporotic vertebral compression fractures: a randomized comparison

Tan Bin, Liu Xiong-wen, Liu Gang, Li Yong-sheng, Qin Zhong-jun, Yang Chun-peng   

  1. Department of Orthopedics, Guangxi Zhuang Autonomous Region Brain Hospital, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China
  • Received:2015-10-26 Online:2016-01-22 Published:2016-01-22
  • About author:Tan Bin, Attending physician, Department of Orthopedics, Guangxi Zhuang Autonomous Region Brain Hospital, Liuzhou 545005, Guangxi Zhuang Autonomous Region, China

摘要:

文章快速阅读:

文题释义:

经皮椎体成形术:是指经皮通过椎弓根或椎弓根外向椎体内注入骨水泥以达到增加椎体强度和稳定性,防止塌陷,缓解疼痛,甚至部分恢复椎体高度为目的一种微创脊椎外科技术。

经皮椎体后凸成形术:是经皮椎体成形术的改良与发展,1999年美国Berkeley骨科医生Mark Reiley研制出一种可膨胀性扩骨球囊,该技术采用经皮穿刺椎体内气囊扩张的方法使椎体复位,在椎体内部形成空间,这样可减小注入骨水泥时所需的推力,而且骨水泥置于其内不易流动。 

 

背景:近年文献显示,采用经皮椎体后凸成形术能有效规避经皮椎体成形术在向病椎内灌注骨水泥时出现的的神经损伤、肺栓塞和椎体高度修复不足等安全隐患。

目的:对比经皮椎体后凸成形与经皮椎体成形术修复骨质疏松椎体压缩性骨折的效果。
方法:将106例老年骨质疏松椎体压缩性骨折患者随机分为2组,试验组(n=53)采用经皮椎体后凸成形术修复,对照组(n=53)采用经皮椎体成形术修复。修复后随访6个月,对比两组椎体压缩变形情况、骨水泥分布情况、椎体中线骨水泥情况、椎体高度恢复情况、骨水泥渗漏、椎体后凸畸形、进行性脊柱塌陷、神经损伤情况,以及目测类比评分与Oswestry功能障碍指数评分。
结果与结论:与对照组比较,试验组骨水泥渗漏和椎体压缩变形少,骨水泥分布均匀,椎体高度恢复好且有效,疼痛缓解更明显,功能障碍少见,且椎体后凸畸形、进行性脊柱塌陷、神经损伤等并发症的概率显著减少(P均< 0.05)。提示经皮椎体后凸成形术能有效缓解骨质疏松椎体压缩性骨折患者的疼痛症状,恢复椎体高度,减少并发症发生率,可有效保障患者预后运动功能的恢复。 

 ORCID: 0000-0002-6349-5261(谭斌)

关键词: 骨科植入物, 脊柱植入物, 经皮椎体后凸成形术, 经皮椎体成形术, 椎体压缩性骨折, 骨水泥渗漏, 骨质疏松

Abstract:

BACKGROUND: Recent literatures have showed that percutaneous kyphoplasty can effectively avoid nerve damage, pulmonary embolism, and insufficient vertebral height and other security risks when bone cement is infused into affected vertebrae in percutaneous vertebroplasty.
OBJECTIVE: To compare the effect of percutaneous kyphoplasty and percutaneous vertebroplasty in repair of osteoporotic vertebral compression fractures.
METHODS: A total of 106 patients with senile osteoporotic vertebral compression fractures were randomly divided into trial group and control group (n=53 per group). Patients in the trial group were treated with percutaneous kyphoplasty, and those in the control group treated with percutaneous vertebroplasty. All patients were followed up for 6 months after repair. The vertebral compression deformation, bone cement distribution, midline vertebral bone cement condition, vertebral height restoration, bone cement leakage, vertebral kyphosis, progressive spinal collapse, nerve damage, as well as visual analog scale scores and Oswestry disability index scores in these two groups were compared.
RESULTS AND CONCLUSION: Compared with the control group, there was less bone cement leakage and vertebral compression deformation in the trial group. Moreouer, in the trial group, bone cement distributed uniformly, vertebral height restoration was good and effective, pain was obviously relieved, and the probability of vertebral kyphosis, progressive spine collapse and nerve damage was significantly reduced (all P < 0.05). These results suggest that percutaneous kyphoplasty can effectively relieve the pain of patients with osteoporotic vertebral compression fractures, restore vertebral body height and reduce the incidence of complications, which effectively guarantees the postoperative restoration of motor function.