论文部分内容阅读
目的探讨经皮椎体成型术治疗胸腰椎骨质疏松性爆裂骨折的安全性、有效性,以及骨水泥渗漏特点。方法采用经皮椎体成型术(percutaneous vertebralplasty,PVP)治疗的单椎体胸腰椎骨质疏松性椎体爆裂骨折(osteo-porotic vertebral burst fracture,OVBF)患者107例。采用VAS评分评价临床疗效,采用椎体前缘及中柱压缩比描述椎体高度,统计术后出现骨水泥渗漏患者的骨水泥渗漏类型及渗漏率。结果所有患者均获得3个月以上随访,VAS评分术后3 d较术前有明显改善(P<0.05),末次随访时较术前及术后3天有明显改善(P<0.05);末次随访时椎体前缘高度及中柱高度较术前均有明显下降(P<0.05)。骨水泥总体渗漏率61.7%,所有渗漏均为无症状渗漏。无骨水泥通过椎体后壁破损的皮质发生渗漏。结论 PVP是胸腰椎骨质疏松性椎体爆裂骨折安全有效的治疗措施。相对于椎体后壁破损的皮质,骨水泥更易通过椎基静脉孔及与椎基静脉相通的椎旁静脉发生渗漏。
Objective To investigate the safety and efficacy of percutaneous vertebroplasty for the treatment of thoracolumbar osteoporotic burst fractures and the characteristics of bone cement leakage. Methods A total of 107 patients with osteoporotic vertebral burst fractures (OVBF) of the thoracolumbar vertebral body underwent percutaneous vertebralplasty (PVP). The VAS score was used to evaluate the clinical efficacy. The vertebral body height was described by the compression ratio of the anterior vertebral body and the mid-column, and the type of cement leakage and the leakage rate were calculated. Results All patients were followed up for more than 3 months. The VAS score was significantly improved 3 days after operation (P <0.05) and significantly improved at the last follow-up (P <0.05) compared with preoperative and postoperative 3 days (P <0.05) At follow-up, the height of the anterior vertebral body and the height of the central column were significantly lower than those before operation (P <0.05). The overall leakage rate of bone cement 61.7%, all leakage were asymptomatic leakage. Bone cement leakage through the cortex damaged vertebral wall. Conclusion PVP is a safe and effective treatment for thoracolumbar osteoporotic vertebral burst fractures. Relative to the cortex damaged vertebral wall, bone cement more easily through the vertebral foramen and vertebral venous vertebral paraventricular vein leakage occurs.