经皮椎体成形、经皮椎体后凸成形灌注骨水泥相关临床应用的再评价

Percutaneous vertebroplasty and percutaneous kyphoplasty with bone cement injection: re-evaluation of their clinical applications

背景:经皮椎体成形和经皮椎体后凸成形是目前治疗骨质疏松性椎体压缩骨折及椎体恶性肿瘤较为理想的方式。目的:综述经皮椎体成形和经皮椎体后凸成形的临床应用、骨水泥渗漏、术后椎体再发骨折及手术方式选择。方法:应用计算机检索万方数据库和Pub Med数据库检索1987年1月至2014年1月期间有关骨水泥椎体成形和椎体后凸成形治疗椎体病变的文献,检索语言限于中文和英文。结果与结论:骨水泥椎体成形和椎体后凸成形具有很多优点,在治疗骨质疏松性椎体压缩骨折和骨转移瘤等疾病上取得了不错的效果,但随着更广泛的应用也呈现出一些问题及争论,临床医生应更加重视手术适应证的选择、围手术期和远期并发症的防治,以及术后骨质疏松症的治疗。

BACKGROUND：Percutaneous vertebroplasty and kyphoplasty are stil ideal ways to osteoporotic vertebral compressive fractures and vertebral metastases at present. OBJECTIVE：To summarize the clinical application of percutaneous vertebroplasty and kyphoplasty, recurrent fractures, bone cement leakage and operation method choice. METHODS： The relevant literatures on percutaneous vertebroplasty and kyphoplasty for treatment of osteoporotic vertebral compressive fractures and bone metastases were retrieved in Wanfang and PubMed （1987-01/2014-01） by computer. Retrieval language was limited to Chinese and English. RESULTS AND CONCLUSION：Vertebroplasty and kyphoplasty have many advantages and have achieved excelent results in the treatment of osteoporotic vertebral compression fractures and bone metastases. With a wider range of applications, however, there are also some problems and controversies. Clinicians should pay more attention to the choice of surgical indications, prevention and therapy of perioperative and long-term complications as well as postoperative osteoporosis treatment.