骨质疏松性椎体骨折术中应用骨填充网袋有效防止骨水泥渗漏

The Application of Intraoperative Bone Filling Mesh Container of Osteoporotic Vertebral Fractures： to Effectively Prevent Leakage of Bone Cement

目的：探讨经皮椎体后凸成形术中应用骨填充网袋治疗骨质疏松性椎体压缩骨折的临床疗效。方法：采用经皮椎体后凸成形术联合骨填充网袋治疗45例单椎体骨质疏松性压缩骨折患者，比较手术前后患者VAS评分、伤椎体前缘高度比及后凸Cobb角。结果：本组骨水泥在伤椎体内分布良好，均无骨水泥外漏发生。术后患者腰背部疼痛均较术前明显减轻，VAS评分由术前8．41±0．67分降至术后1．35±0．59分。本组均获随访，时间6～12个月。脊柱后凸Cobb角由术前的21．25°±1．50°矫正至术后的15．60°±7．06°，术后6个月矫正度未见丢失（P〉0．05）。伤椎前缘高度比由术前的63．97％±11．23％矫正至术后的79．29％±10．76％，术后6个月椎体前缘高度比与术后比较，差异无统计学意义（P〉0．05）。结论：经皮椎体后凸成形术中应用骨填充网袋灌注聚甲基丙烯酸甲酯骨水泥治疗骨质疏松性椎体压缩骨折，在改善疼痛、恢复伤椎体高度、矫正脊柱后凸畸形等方面疗效满意．可有效降低骨水泥椎体外渗漏率。

Objectiv： Percutaneous vertebroplasty（PVP） and percntaneous kyphoplasty（PKP） have the advantages of definite efficacy, less trauma and less complications, and become the main means to treat vertebral compression fractures in clinic. But there are also some serious complications, such as outward leakage of cement. Application of bone filling mesh containers to wrap the bone cement in the operation, to restore the injured vertebral height, and can make a small amount of bone cement into the bone trabecular space through the mesh, forming micro interlocking, to reinforce the purpose of vertebral injury. To investigate the clinical effect of application of bone filling mesh containers in treatment of osteoporotic vertebral compression fractures in PKP during surgery. Methods： PKP combined with bone filling mesh container for treatment of 45 cases of single vertebral osteoporotic compression fracture patients. The VAS score, anterior vertebral height and kyphosis Cobb angle were compared between the patients before and ＂after the operation. Results： The bone cement of the group was well distributed in the injured vertebral body, and no bone cement leakage occurred. The pain of the waist and back of the patients was significantly lower than preoperative, and the VAS score decreased from （8.41±0. 67）to（ 1.35 ± 0.59）. All the patients were followed up for 6 12 months. The Cobb angle of kyphosis was corrected by preoperative （21.25±1.50） to postoperative （ 15.60 ± 7.06 ） , and the correction was not lost 6 months after operation （ P 〉0. 05 ）. The anterior edge height of the injured vertebra was corrected by 63.97% ± 11.23% to 79.29% ± 10.76% , and compared with the postoperative, the anterior vertebral height of the 6 months after operation did not change significantly （ P 〉 0.05 ） . Conclusion： The bone filling mesh container for the treatment of osteoporotic vertebral compression fractures during PKP, in improving pain and restore the vertebral height and correct kyphosis were satisfactory, can effectively reduce the bone cement leakage rate.