CAJ | 학술논문

生物材料%生物材料学术探讨%骨水泥充填材料%经皮椎体成形术%经皮椎体后凸成形术%骨质疏松性压缩性骨折%骨水泥渗漏%椎体容积%目测类比评分%硫酸钙骨水泥%磷酸钙骨水泥%珍珠母%石珊瑚颗粒生物材料%生物材料學術探討%骨水泥充填材料%經皮椎體成形術%經皮椎體後凸成形術%骨質疏鬆性壓縮性骨摺%骨水泥滲漏%椎體容積%目測類比評分%硫痠鈣骨水泥%燐痠鈣骨水泥%珍珠母%石珊瑚顆粒
생물재료%생물재료학술탐토%골수니충전재료%경피추체성형술%경피추체후철성형술%골질소송성압축성골절%골수니삼루%추체용적%목측류비평분%류산개골수니%린산개골수니%진주모%석산호과립

背景:椎体骨质疏松性压缩骨折多发生于骨质钙丢失严重的老年人群,轻微的外力就可以引起椎体骨折,近年来发展起来的经皮椎体成形治疗骨质疏松性压缩性骨折效果较好.目的:探讨骨水泥充填治疗多节段骨质疏松性压缩性骨折的疗效及材料的特性.方法:采用骨水泥充填材料经皮椎体成形治疗多椎体骨质疏松性压缩骨折患者32例,共158个椎体.治疗后复查 X 射线、CT 等辅助检查,了解骨折椎体复位情况、椎体的容量变化、骨水泥分布及外漏情况,用 CT 容量分析法检测治疗前后椎体的容积变化,观察疼痛强度评价的目测类比评分变化,分析发生骨水泥渗漏的原因.结果与结论:纳入结果分析32例,158个椎体.注射骨水泥后无神经根及脊髓损伤,无肺栓塞及心脑血管系统急性反应.①治疗后随访6-16个月,平均随访10个月,无严重并发症和椎体塌陷.②治疗前椎体体积为(22.2±8.6) cm3,治疗后增至(24.8±6.9) cm3,体积变化差异有统计学意义(P <0.05).③6个椎体发生骨水泥渗漏,分别为椎管内硬膜外2个、椎旁静脉4个,可能与椎体后缘爆裂、骨水泥黏度过低以及注射速度过快有关.④治疗后48 h 目测类比评分为(2.2±3.7)分,较治疗前(8.3±1.6)分显著下降(t=25.2,P <0.05).作者认为,对于多节段骨质疏松性压缩性骨折,采用充分的治疗前准备和恰当的方法,选择合适的骨水泥充填材料,一期行经皮椎体成形治疗是安全可行的,可明显缓解患者的疼痛症状,治疗中操作要注意防止骨水泥渗漏.
배경:추체골질소송성압축골절다발생우골질개주실엄중적노년인군,경미적외력취가이인기추체골절,근년래발전기래적경피추체성형치료골질소송성압축성골절효과교호.목적:탐토골수니충전치료다절단골질소송성압축성골절적료효급재료적특성.방법:채용골수니충전재료경피추체성형치료다추체골질소송성압축골절환자32례,공158개추체.치료후복사 X 사선、CT 등보조검사,료해골절추체복위정황、추체적용량변화、골수니분포급외루정황,용 CT 용량분석법검측치료전후추체적용적변화,관찰동통강도평개적목측류비평분변화,분석발생골수니삼루적원인.결과여결론:납입결과분석32례,158개추체.주사골수니후무신경근급척수손상,무폐전새급심뇌혈관계통급성반응.①치료후수방6-16개월,평균수방10개월,무엄중병발증화추체탑함.②치료전추체체적위(22.2±8.6) cm3,치료후증지(24.8±6.9) cm3,체적변화차이유통계학의의(P <0.05).③6개추체발생골수니삼루,분별위추관내경막외2개、추방정맥4개,가능여추체후연폭렬、골수니점도과저이급주사속도과쾌유관.④치료후48 h 목측류비평분위(2.2±3.7)분,교치료전(8.3±1.6)분현저하강(t=25.2,P <0.05).작자인위,대우다절단골질소송성압축성골절,채용충분적치료전준비화흡당적방법,선택합괄적골수니충전재료,일기행경피추체성형치료시안전가행적,가명현완해환자적동통증상,치료중조작요주의방지골수니삼루.
@@@@BACKGROUND: Vertebral osteoporotic compression fractures often occur in the elderly with serious bone calcium loss, and light external forces can cause vertebral fractures. The percutaneous vertebroplasty developed recently has better effect for the treatment of osteoporotic compression fractures. OBJECTIVE: To explore the effect and material characteristics of bone cement for the treatment of multi-segment osteoporotic compression fractures. METHODS: Thirty-two patients (158 vertebral bodies) with osteoporotic compression fractures were treated with bone cement through percutaneous vertebroplasty. Review X-ray and CT scanning were performed after treatment to understand the fracture vertebra reduction, changes of vertebral capacity, bone cement distribution and leakage situation. The change of the volume of vertebral body before and after treatment was detected with CT volumetric analysis, the change of visual analog scale was observed and the reason for bone cement leakage was analyzed. RESULTS AND CONCLUSION: Al the 32 patients (158 vertebral bodies) were included in the final analysis. There were no nerve root and spinal cord injuries, no pulmonary embolism and no cardiovascular system acute response after injection of bone cement. Al the patients were fol owed-up for 6-16 months after treatment, averaged in 10 months, and there were no serious complications or vertebral col apse. The vertebral volume before treatment was (22.2±8.6) cm3 and increased to (24.8±6.9) cm3 after treatment, and the difference was significant (P < 0.05). Six vertebral bodies appeared bone cement leakage, including two bone cement leakage in spinal epidural and four bone cement leakage in paravertebral vein, and the leakage may related to the posterior margin burst, low bone cement viscosity and fast injection speed. The visual analog scale score (2.2±3.7) at 48 hours after treatment was significantly lower than (8.3±1.6) before treatment (t=25.2, P < 0.05). The adequate pre-treatment preparation, proper method, suitable bone cement materials combined with percutaneous vertebroplasty is safe and feasible for the treatment of multi-segment osteoporotic compression fractures, which can significantly al eviate pain in the patients, and we should pay attention to prevent the leakage of bone cement during operation.