骨填充网袋治疗骨质疏松性椎体爆裂性骨折的临床应用

Clinical application of bone filling mesh-container in the treatment of osteoporotic spinal burst fracture

目的评估骨填充网袋治疗骨质疏松性椎体爆裂性骨折的临床疗效及安全性。方法回顾性分析骨填充网袋治疗骨质疏松性椎体爆裂性骨折36例。通过评估术前、术后3天、术后1年VAS评分、椎体前缘高度比及后凸Cobb角变化,观察骨水泥弥散及渗漏情况。结果 35例手术顺利完成,骨水泥弥散良好,充盈满意,无渗漏,1例出现网袋松动。随访其术前、术后3天及1年VAS评分分别为:(8.35±1.32)、(2.01±1.12)、(1.98±1.34),椎体前缘高度比分别为:(47.3±9.4)%、(75.1±7.0)%、(74.1±7.1)%,Cobb角分别为:17.1°±7.3°、8.1°±5.4°、8.7°±5.5°,上述指标术后与术前相比差异有统计学意义(P<0.05),术后两者相比差异无统计学意义(P>0.05)。结论使用骨填充网袋治疗骨质疏松性椎体爆裂性骨折能够有效的缓解疼痛、纠正后凸,具有降低骨水泥外渗风险等优点。

Objective To evaluate the clinical efficacy and safety of bone filling mesh-container on the curing of osteoporotic spinal burst fracture. Methods Retrospect analyzed 36 patients with osteoporotic spinal burst fracture by the treatment of bone filling mesh-container.By the assessment of visual analog scales（ VAS）,measurement the ratio of anterior vertebral height and the changes of cobb angle,the observation of bone cement dispersion and leakage. Results 35 cases were successfully completed,the bone cement dispersion good and satisfactory filling,no cement leakage in all case of successful cases,1 case of bone filling mesh-container loose; VAS score from 8. 35 ± 1. 32 preoperatively improved to 2. 01 ±1. 12 at 3 days after operation,and 1.98±1.34 at 1 year after operation. The ratio of anterior vertebral height from（ 47.3 ±9. 4） % preoperatively recovered to（ 75.1± 7.0） % at 3 days after operation,and（ 74.1 ± 7.1） % at 1 year after operation.Cobb angle from 17.1° ± 7.3° preoperatively corrected to 8.1° ± 5.4° at 3 days after operation,and 8.7° ± 5.5°at 1 year after operation; There was statistically significant difference between the preoperative and the postoperative data about the above 3indicators（ P〈0.05）,there was no statistically significant difference between 3 days and after 1 year of postoperative data about the above 3 indicators（ P〉0.05）. Conclusion Use Bone filling mesh-container treatment of osteoporotic vertebral burst fracture can effectively relieve pain,correct kyphosis,with a reduced risk of bone cement leakage.