医用骨水泥在骨质疏松患者行椎弓根钉固定中的作用

Clinical study of applying bone cement to pedicle screw fixation in osteoporotic patients

目的:探讨应用骨水泥在骨质疏松患者行椎弓根钉固定术的临床效果和安全性。方法:对20例骨质疏松患者经骨水泥灌注后行椎弓根钉固定术,比较患者术后1周和复查时的X线片,观察内置物有无松动,骨水泥固定螺钉周围有无透亮线出现。并对复查患者行固定节段的CT扫描,观察螺钉周围有无透亮线出现。结果:18例(90%)患者获随访,平均随访时间18个月,线片中均未发现内置物松动或脱出,固定节段植骨愈合良X好,在骨水泥固定螺钉周围未发现有透亮线出现;CT扫描在螺钉周围也未发现透亮线出现。结论:对于骨质疏松患者,应用骨水泥对椎弓根钉固定进行加固可防止内置物松动脱出,有较好稳定脊柱的临床效果。但应注意手术技巧,确保没有骨水泥渗漏。

Objective:To investigate the clinical effect and safety of applying bone cement to pedicle screw fixation in osteoporotic patients.Method:A series of 20 patients,in whom the pedicle screw fixation was performed with methylmethacrylate(PMMA) injected into the tract,were followed up.By comparing their X-ray expressions at the time of one week after the operation with that at the time of several months after the operation when the patients came back for a further consultation,whether the screws were mobile should be judged.Furthermore,the involved spinal segments were scaned by CT to observe if any bright lines exist around the screws.Result:18 patients(90%) were followed up,the mean follow-up period was 18 months.There was no screw mobility observed in the X-ray expression of all the cases.And there was no bright line found in the CT expression.Conclusion:To applying PMMA bone cement to pedicle screw fixation in osteoporotic patients can immobilize pedicle screw and stabilize vertebrae,and,as a result,gain a satisfactory clinical effect when the operation is carefully done without the leakage of bone cement.