球囊扩张-椎体后凸成形术治疗骨质疏松性椎体压缩骨折并发骨水泥渗漏分析

Cement leakage in patients with osteoporotic vertebral compression fractures treated by percutaneous balloon kyphoplasty

目的分析球囊扩张-椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折骨水泥渗漏情况。方法收集本科2007年12月至2010年12月采用PKP治疗椎体压缩性骨折患者138例,男性41例,女性97例,平均75.3(56～87)岁。其中单椎体骨折115例,双椎体骨折19例,三椎体骨折2例,四椎体骨折2例;共167个椎体,其中T6 3个,T7 4个,T8 4个,T9 6个,T10 6个,T11 21个,T12 43个,L1 45个,L2 23个,L3 7个,L4 5个。结果共12例(8.7%)患者发生骨水泥渗漏,其中渗漏至椎间隙5例,椎体前方4例,椎旁软组织1例,沿椎弓根穿刺通道渗入根管内1例,椎管内1例;未出现脊髓或神经损伤的症状和体征。结论 PKP治疗椎体压缩性骨折有一定的骨水泥渗漏率,存在造成严重后果的并发症的可能性,应重视骨水泥渗漏的积极预防。

Objective To analyze cement leakage in patients with osteoporotic vertebral compression fractures treated by percutaneous balloon kyphoplasty（PKP）.Methods One hundred and thirty-eight patients with osteoporotic vertebral compression fractures（41 males and 97 females） at the age of 56 to 87 years（mean 75.3 years） in admitted to our department from December 2007 to December 2010 for PKP were enrolled in this study.Of these patients,115 were diagnosed with a single vertebral fracture,19 with 2 vertebral fractures,2 with 3 vertebral fractures,2 with 4 vertebral fractures.A total of 167 vertebrae were involved,including 3 at T6,4 at T7,4 at T8,6 at T9,6 at T10,21 at T11,43 at T12,45 at L1,23 at L2,7 at L3,and 5 at L4.Results Cement leakage occurred in 12 patients（8.7%）,with inter-vertebral space leakage in 5,anterior vertebral body leakage in 4,para-vertebral leakage in 1,foramen leakage in 1,and spinal canal leakage in 1.No severe symptoms and signs of spinal or nerve injury were noted.Conclusion Cement leakage may occur in patients with osteoporotic vertebral compression fractures after PKP treatment,which may lead to severe complications,thus stress should be laid on its prevention.