重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
11期
1457-1459,1462
,共4页
椎体成形术%骨质疏松%爆裂骨折%骨水泥渗漏%椎基静脉孔
椎體成形術%骨質疏鬆%爆裂骨摺%骨水泥滲漏%椎基靜脈孔
추체성형술%골질소송%폭렬골절%골수니삼루%추기정맥공
vertebroplasty%osteoporosis%vertebral burst fractures%leakage of bone cement%basivertebral foramen
目的：通过经皮椎体后凸成形术（PKP）治疗骨质疏松性爆裂骨折（OVBF），评估临床疗效及探寻骨水泥向椎管内渗漏的途径。方法根据AO分型，将2005年10月至2013年5月鄂尔多斯市中心医院收治的OVBF患者45例（45个椎体），采用PKP治疗，通过术后CT平扫确定骨水泥向椎管内、椎间隙渗漏的途径，测量术前、术后椎体高度、Cobb角、椎管狭窄改善情况。比较术前、术后视觉模拟评分（VAS）变化情况。结果骨水泥向椎管内渗漏2例，渗漏途径主要是通过椎基静脉孔，骨水泥向上位椎间隙渗漏高于下位椎间隙。椎体高度恢复、Cobb矫正、VAS术前、术后比较，差异有统计学意义（P＜0．05）。椎管狭窄率术前、术后比较，差异无统计学意义（P＞0．05）。结论PKP治疗OVBF不是禁忌证，OVBF经PKP治疗后骨水泥向椎管内渗漏主要途径是椎基静脉孔，向椎间隙渗漏与终板损伤有关。
目的：通過經皮椎體後凸成形術（PKP）治療骨質疏鬆性爆裂骨摺（OVBF），評估臨床療效及探尋骨水泥嚮椎管內滲漏的途徑。方法根據AO分型，將2005年10月至2013年5月鄂爾多斯市中心醫院收治的OVBF患者45例（45箇椎體），採用PKP治療，通過術後CT平掃確定骨水泥嚮椎管內、椎間隙滲漏的途徑，測量術前、術後椎體高度、Cobb角、椎管狹窄改善情況。比較術前、術後視覺模擬評分（VAS）變化情況。結果骨水泥嚮椎管內滲漏2例，滲漏途徑主要是通過椎基靜脈孔，骨水泥嚮上位椎間隙滲漏高于下位椎間隙。椎體高度恢複、Cobb矯正、VAS術前、術後比較，差異有統計學意義（P＜0．05）。椎管狹窄率術前、術後比較，差異無統計學意義（P＞0．05）。結論PKP治療OVBF不是禁忌證，OVBF經PKP治療後骨水泥嚮椎管內滲漏主要途徑是椎基靜脈孔，嚮椎間隙滲漏與終闆損傷有關。
목적：통과경피추체후철성형술（PKP）치료골질소송성폭렬골절（OVBF），평고림상료효급탐심골수니향추관내삼루적도경。방법근거AO분형，장2005년10월지2013년5월악이다사시중심의원수치적OVBF환자45례（45개추체），채용PKP치료，통과술후CT평소학정골수니향추관내、추간극삼루적도경，측량술전、술후추체고도、Cobb각、추관협착개선정황。비교술전、술후시각모의평분（VAS）변화정황。결과골수니향추관내삼루2례，삼루도경주요시통과추기정맥공，골수니향상위추간극삼루고우하위추간극。추체고도회복、Cobb교정、VAS술전、술후비교，차이유통계학의의（P＜0．05）。추관협착솔술전、술후비교，차이무통계학의의（P＞0．05）。결론PKP치료OVBF불시금기증，OVBF경PKP치료후골수니향추관내삼루주요도경시추기정맥공，향추간극삼루여종판손상유관。
Objective To evaluate the clinical curative efficacy and to explore the leaking pathway of bone cement to verte‐bral canal through treating osteoporotic vertebral burst fractures (OVBF) by using percutaneous kyphoplasty(PKP) .Methods Ac‐cording to AO classification ,45 OVBF patients with 45 vertebras in the Erdos Central Hospital from October 2005 to May 2013 were treated by using PKP .The pathway of bone cement leaking to spinal canal and intervertebral space was determined by postop‐erative CT plain scan .The postoperative vertebral height ,Cobb angle and spinal stenosis improvement were measured .The change of VAS were compared between before and after operation .Results There were 2 cases of bone cement leaking to spinal canal .The leaking passway was mainly through basivertebral foramen .The leakage of bone cement to superior intervertebral space was higher than that to lower intervertebral space .The recovery of the vertebral height ,correction of Cobb angle and pre‐and post‐operative VAS scores had statistically significant differences (P<0 .05) .The spinal stenosis rate had no statistical difference between before and after operation(P>0 .05) .Conclusion PKP for treating OVBF is not a contraindication .The main pathway of bone cement lea‐king to spinal canal is basivertebral foramen after the treatment of OVBF by using PKP ,the leakage to intervertebral space is relat‐ed with the endplate damage .
