经皮脊柱后凸成形术中骨水泥的应用体会

Experiences of Using Bone Cement in Percutaneous Kyphoplasty

目的探讨经皮脊柱后凸成形手术中骨水泥的应用疗效。方法 2008年10月2010年10月,应用注射用Ⅲ型丙烯酸树脂骨水泥及其椎体成形系统,采取经皮脊柱后凸成形术治疗40例椎体疾病患者。其中男5例,女35例;年龄53～84岁,平均65岁。老年骨质疏松性椎体压缩骨折37例,椎体恶性肿瘤2例,椎体血管瘤1例。采用视觉模拟评分(visual analogue scale,VAS)对患者手术前后疼痛程度的改善情况进行评分统计,并观察术中及术后并发症的发生情况。结果患者出院前行脊柱正、侧位透视,发现椎体内骨水泥分布良好;3例有少量骨水泥向椎体外渗漏现象,但均无临床症状。所有患者获随访1～12个月,平均8个月。腰背部疼痛均明显缓解或消失,日常生活质量大大提高。术前VAS评分为(8.30±0.48)分,术后3d、1个月及末次随访时VAS评分分别为(3.11±0.41)、(2.50±0.36)、(2.50±0.36)分,与术前比较差异均有统计学意义(P<0.05)。结论骨水泥应用于经皮脊柱后凸成形手术中可取得很好疗效,固化的骨水泥对脊柱起到很好的支撑、稳定作用。

Objective To assess the clinical effect of using bone cement in percutaneous kyphoplasty.Methods From October 2008 to October 2010,type Ⅲ Acrylic resin bone cement and the system of vertebroplasty were used in percutaneous kyphoplasty（PKP） to treat 40 patients.There were 5 males and 35 females with an average of 65 years old（53-84 years）.There were 37 older patients with osteoporotic vertebral compression fracture,2 cases of vertebral tumor and one hemangioma.Visual analogue scale（VAS） was used to evaluate the pain before and after the operation.The complications in and after the operation were also recorded.Results Before discharge,posterior-anterior and lateral X-ray films were taken to evaluate the distribution of bone cement.Three patients showed a little bone cement leakage from the vertebral body,but no clinical symptoms were found.All patients were followed for 1 to 12 months with an average of 8 months.Pain in the back decreased obviously or disappeared,and the qualities of daily life were improved greatly.The score of VAS was（8.30±0.48） before the operation,and（3.11±0.41）,（2.50±0.36）,and（2.50±0.36） 3 days,1 month after the operation,and during the last follow-up,respectively.Significant differences were found between the VAS score before and after operation（P0.05）.Conclusions Good results can be expected when bone cement is used in percutaneous kyphoplasty.Solidified bone cement can effectively support and stablize the spinal column.