微创球囊扩张椎体后凸成形术治疗胸腰椎压缩骨折

The expansion of minimally invasive balloon kyphoplasty treatment of thoracolumbar vertebral compression fractures

目的探讨经微创球囊扩张椎体后凸成形术治疗脊柱压缩骨折的疗效。方法在C型臂X线机引导下,采用微创穿刺方法 ,将特制耐高压球囊送入伤椎,用装有压力显示计的高压注射器,向球囊内缓慢匀速注入造影剂,球囊扩张,从而将被压缩的松质骨向四周挤压,使伤椎膨胀并恢复一定高度,经C型臂X线机透视观察确认纠正后凸畸形及恢复高度满意后计量压力与容量,抽出造影剂。将同量含钡拉丝后期骨水泥注入由球囊扩张而产生的空腔内,通过C型臂X线机观察确认骨水泥充满空腔,骨水泥推杆夯压骨水泥直至其完全固化后完成手术。结果 19例患者术后疼痛即刻消失,术后24 h内即可下床活动。经X线检查确认压缩骨折的椎体高度恢复理想,术前Cobb角平均为25.8°,术后2 d平均10.9°(P<0,05)。术后随访1～28个月,患者均恢复伤前生活方式,无疼痛,伤椎高度维持较好,无并发症发生。结论微创球囊扩张椎体后凸成形术是治疗胸腰椎压缩骨折安全有效的方法 。

Objective To study the expansion of minimally invasive balloon kyphoplasty treatment of vertebral compression fractures. Methods In the C - ann X - ray machine to guide the introduction of minimally invasive puncture method, high voltage will be a special balloon into the vertebral injury, and showed that with the pressure of high - pressure syringe. Uniform to the balloon slowly injected contrast agent, balloon dilatation, which will be compressed to the cancellous bone around the extrusion, so that expansion of injury and to restore some vertebral height. By C - arm X - ray machine to confirm correct perspective kyphosis observation and measurement of the satisfaction of the resumption of high pressure and capacity, taking the contrast agent. Will be drawing the same amount of barium with the late injection of bone cement caused by balloon dilatation of the cavity, through the C - arm X - ray observation confirmed cavity filled with bone cement, bone cement cement putting pressure tamping until the completion of its fully cured surgery. Results 19 cases of patients with immediate postoperative pain disappeared within 24 h after the activities to get out of bed. Confirmed by X- ray examination of the vertebral body compression fractures to restore the ideal height, the average preoperative Cobb angle was 25.8°, after 2 d on average 10. 9° （P 〈0.05 ）. Patients were followed up for 1 -28 months, patients returned to pre -injury lifestyle,without pain, injury of vertebral height to maintain a good, no complications occurred. Conclusion The expansion of minimally invasive balloon kyphoplasty is a treatment of thoracolumbar vertebral compression fractures is safe and effective method.