单侧椎弓根穿刺球囊扩张-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 following unilateral balloon-kyphoplasty for osteoporotic vertebral compression fractures

目的分析单侧椎弓根穿刺球囊扩张-椎体后凸成形术（BK）治疗骨质疏松性椎体压缩骨折的骨水泥渗漏情况。方法 2007-12-2010-12采用单侧椎弓根穿刺BK治疗96例椎体压缩性骨折患者。男性26例,女性70例;年龄56~87岁,平均72.6岁。其中单椎体骨折77例,双椎体骨折15例,三椎体骨折2例,四椎体骨折2例,共121个椎体,其中T6 2个,T7 2个,T8 4个,T9 4个,T10 6个,T11 11个,T12 25个,L1 27个,L2 13个,L3 5个,L4 3个。结果共8例（8.3%）患者发生骨水泥渗漏。其中渗漏至椎间隙3例,椎体前方3例,沿椎弓根穿刺通道渗入根管内1例,椎管内渗漏1例,未出现脊髓或神经损伤的症状和体征。结论单侧椎弓根穿刺BK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可能性,应重视骨水泥渗漏的积极预防。

Objective To investigate the cement leakage following unilateral balloon-kyphoplasty（BK）for osteoporotic vertebral compression fractures.Methods From December 2007 to December 2010.96 patients with vertebral compression fracture underwent BK,there were 26 males and 70 females,with the age range from 56 to 87 years（average,72.6 years）;77 cases had one level fracture,15 cases had two levels fracture,2 cases had three levels,2 cases had four levels involved,there were a total of 121 vertebrae involved,which including 2 in T6,2 in T7,4 in T8,4 in T9,6 in T10,11 in T11,25 in T12,27 in L1,13 in L2,5 in L3,3 in L4.The cement leakage were reviewed retrospectively.Results Cement leakage occurred in 8 cases（8.3%）intervertebral space leakage in 3 cases,vertebral body leaking anteriorly in 3 cases,foramen leakage in 1 case,spinal canal extravasation in 1 case;No serious complications were noted.Conclusion Cement leakage may occur during unilateral BK,which may cause serious results.More attention should be paid on the prevention of cement leakage.