经皮钛网骨水泥填充治疗骨质疏松性椎体压缩骨折

Percutaneous vertebral augmentation with titanium mesh and bone cement for osteoporotic vertebral compres sion fractures

[目的]介绍经皮钛网骨水泥填充治疗老年性骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fractures,OVCFs)的临床技术与初步效果。[方法]2016年5月~2018年5月,使用经皮钛网置入支撑骨水泥填充治疗OVCFs30例。术中透视定位责任椎体的双侧椎弓根,逐渐置入穿刺针,达到椎体中前1/3,将球囊带钛网支架沿外套管置入椎体内,扩张以撑开椎体恢复高度后,钛网同时释放,注入骨水泥。[结果]30例患者均顺利完成手术。随时间推移VAS和ODI评分均显著降低,不同时间点间差异有统计学意义(P<0.05)。影像检查显示,术中正位骨水泥弥散过中线,侧位像弥散占比椎体4/5,骨水泥分布均匀。术后Beck指数和Cobb角较术前显著减小,差异有统计学意义(P<0.05)。[结论]钛网置入支撑骨水泥填充是治疗老年性OVCFs的有效方法,能较好维持强化后椎体的高度及稳定性。

[Objective]To introduce the surgical technique and primary clinical outcomes of percutaneous vertebral aug mentation with titanium mesh and bone cement for senile osteoporotic vertebral compression fractures(OVCFs).[Methods]From May 2016 to May 2018,a total of 30 patients received percutaneous vertebral augmentation with titanium mesh and bone cement for OVCFs.After locating the pedicle roots of affected vertebra by fluoroscopy,a puncture needle was placed to the ante rior-middle portion of the vertebral body.A tube with titanium mesh was inserted into the vertebral body following the guider needle,and dilated the body to regain the vertebral height,subsequently released the titanium mesh and injected bone cement.[Results]All the 30 patients had operation performed smoothly.As time went the VAS and ODI scores significantly decreased,which proved statistically significant among time points(P<0.05).The radiographic examination revealed the bone cement dif fused over the middle line of the vertebral body on the anteroposterior view and 4/5 body on the lateral view with proper distribu tion.Both the Beck index and Cobb angle significantly decreased after operation in contrast to those before operation with signif icant differences(P<0.05).[Conclusions]This percutaneous vertebral augmentation with titanium mesh and bone cement is an effective method for the treatment of senile OVCFs,and facilitates to regain vertebral height and stability.