骨质疏松性胸腰椎骨折经皮椎体后凸成形术后并发骨水泥渗漏的临床观察及分析

Clinical observation and analysis of bone cement leakage complicated by percutaneous kyphoplasty for osteoporotic thoracolumbar fracture

目的临床观察和分析骨质疏松性胸腰椎骨折患者接受经皮椎体后凸成形术(PKP)治疗后并发骨水泥渗漏情况。方法回顾性分析我院2011年1月至2013年9月采用PKP治疗的97例(114椎)骨质疏松性胸腰椎骨折患者的临床资料,通过术后X线片和CT检查观察患者术后骨水泥渗漏情况。根据椎体外骨水泥渗漏的解剖位置,将渗漏分为椎旁型、椎间盘型、椎管型、椎弓根型和混合型(2种或2种以上)。结果70例患者(85椎)无骨水泥渗漏;27例患者(29椎)出现骨水泥渗漏,其中11椎为椎旁型,4椎为椎间盘型,6椎为椎管型,3椎为椎弓根型,5椎为混合型。渗漏发生率为25.4%。结论 PKP治疗骨质疏松性胸腰椎骨折效果良好,但是术后骨水泥渗漏发生率较高,其中以椎旁型渗漏及椎管型渗漏最为多见。

Objective To observe and analyze the bone cement leakage complicated by percutaneous kyphoplasty （PKP） in treatment of osteoporotic thoracolumbar fracture. Methods The data of 97 patients （114 vertebras） with osteoporotic thoracolumbar fracture treated by PKP in our hospital from January 2011 to September 2013 was retrospectively analyzed. The bone cement leakage was observed and analyzed by postoperative X-ray and CT examination. Accroding to the local anatomical location of bone cement leakage, the leakage was classified into 5 types, namely the paravertebral type, disc type, vertebral canal type, pedicle type and mixed type （including two or more types）. Results In all patients, 70 cases （85 vertebras） without bone cement leakage occurred, 27 patients （29 vertebras） complicated with cement leakage, including 11 of paravertebral type, 4 of disc type, 6 of vertebral canal type, 3 of pedicle type and 5 of mixed type. The leakage rate was 25. 4%. Conclusions The PKP treatment for osteoporotic thoracolumbar fracture gets better effect, but with a high incidences of cement leakage. Therein the leakage of paravertebral and vertebral canal are the most common types.