• 四川大學華西醫院手術室(成都,610041);
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【摘要】 目的  探討經皮脊柱后凸成形手術中骨水泥的應用療效。 方法  2008年10月-2010年10月,應用注射用Ⅲ型丙烯酸樹脂骨水泥及其椎體成形系統,采取經皮脊柱后凸成形術治療40例椎體疾病患者。其中男5例,女35例;年齡53~84歲,平均65歲。老年骨質疏松性椎體壓縮骨折37例,椎體惡性腫瘤2例,椎體血管瘤1例。采用視覺模擬評分(visual analogue scale,VAS)對患者手術前后疼痛程度的改善情況進行評分統計,并觀察術中及術后并發癥的發生情況。 結果  患者出院前行脊柱正、側位透視,發現椎體內骨水泥分布良好;3例有少量骨水泥向椎體外滲漏現象,但均無臨床癥狀。所有患者獲隨訪1~12個月,平均8個月。腰背部疼痛均明顯緩解或消失,日常生活質量大大提高。術前VAS評分為(8.30±0.48)分,術后3 d、1個月及末次隨訪時VAS評分分別為(3.11±0.41)、(2.50±0.36)、(2.50±0.36)分,與術前比較差異均有統計學意義(P lt;0.05)。 結論  骨水泥應用于經皮脊柱后凸成形手術中可取得很好療效,固化的骨水泥對脊柱起到很好的支撐、穩定作用。
【Abstract】 Objective  To assess the clinical effect of using bone cement in percutaneous kyphoplasty. Methods  From October 2008 to October 2010, type Ⅲ Acrylic resin bone cement and the system of vertebroplasty were used in percutaneous kyphoplasty (PKP) to treat 40 patients. There were 5 males and 35 females with an average of 65 years old (53-84 years). There were 37 older patients with osteoporotic vertebral compression fracture, 2 cases of vertebral tumor and one hemangioma. Visual analogue scale (VAS) was used to evaluate the pain before and after the operation. The complications in and after the operation were also recorded. Results  Before discharge, posterior-anterior and lateral X-ray films were taken to evaluate the distribution of bone cement. Three patients showed a little bone cement leakage from the vertebral body, but no clinical symptoms were found. All patients were followed for 1 to 12 months with an average of 8 months. Pain in the back decreased obviously or disappeared, and the qualities of daily life were improved greatly. The score of VAS was (8.30±0.48) before the operation, and (3.11±0.41), (2.50±0.36), and (2.50±0.36) 3 days, 1 month after the operation, and during the last follow-up, respectively. Significant differences were found between the VAS score before and after operation (P lt;0.05). Conclusions  Good results can be expected when bone cement is used in percutaneous kyphoplasty. Solidified bone cement can effectively support and stablize the spinal column.

引用本文: 李關平,安晶晶,洪瑛. 經皮脊柱后凸成形術中骨水泥的應用體會. 華西醫學, 2011, 26(11): 1663-1665. doi: 復制