经皮后凸成形术的临床应用进展

Progress in clinical application on percutaneous kyphoplasty

经皮后凸成形术是一种用于治疗骨质疏松性椎体压缩骨折的微创手术。该技术是将球囊置入椎体,通过球囊使骨折椎体"扩张",从而创造一空间,然后将骨水泥注入其内,以达到缓解疼痛、恢复椎体高度和减少后凸畸形的治疗目的。目前,关于PKP的一些新方法与新器械日趋发展,包括SKY,PBG,Vessel-X骨材料填充器等。新的填充材料(人造骨替代物如复合树脂材料,碳酸钙或硫酸钙骨水泥)和骨水泥成分正用于临床。然而,人们仍未科学的阐明如何评估和选择合适的患者,使用何种充填材料,怎样充填材料,长期临床结果如何,手术的安全措施等诸多问题。笔者就这一技术的发展概要、方法、充填材料及技术等研究进展进行概述。

Percutaneous kyphoplasty（PKP） is a minimally invasive technique in treatment of osteoporosis vertebra compressed fracture（ OVCF）. The aim of PKP is pain relief combined with restoration of vertebral body height and reduction in kyphosis. This is achieved by ＂expanding＂ the fractured vertebra with a balloon and then filling of the resultant cavity with cement. Nowadays, several new methods and instruments about PKP are under progress, including SKY,percutaneous bone graft（PBG）, Vessel-X bone void filling container system,and so on. New filler materials（ synthetic bone substitutes, e.g., composite resin materials, calcium phosphate or calcium sulfate cements） in addition to new PMMA formulations are now available for clinical use. However, the scientific evidence does not clarify how to evaluate and select appropriate patient, what material to use, how to deliver the material, what the long-term consequences are, and what the safety profile is for this procedure. This paper overviews the current progress in the research on PKP development synopsis, methods, filling materials and techniques.