网袋成形术治疗后壁破裂型颈椎转移性骨折

Vesselplasty for the treatment of metastatic cervical spine fracture of posterior wall rupture type

目的 探讨网袋成形术治疗后壁破裂型颈椎转移性骨折的安全性和有效性。方法 回顾性分析26例网袋成形术治疗的后壁破裂型颈椎转移性骨折患者的临床资料。记录手术成功率、手术时间、骨水泥用量、骨水泥泄露以及并发症发生情况。比较术前和术后VAS、NDI评分。结果 26例患者共27个椎体均成功完成手术。手术时间为(37.9±11.4)min,骨水泥用量为(3.1±0.5)mL。4个椎体发生骨水泥泄露,其中Ⅰ型泄露1例,Ⅳ型泄2例,Ⅴ型泄露1例,均为无症状泄露。术前椎体高度为(0.7±0.2)cm,术后高度为(1.2±0.3)cm,差异有统计学意义(P<0.01)。术前VAS评分为(7.6±1.3)分,术后3 d VAS评分为(3.1±1.5)分,差异有统计学意义(P<0.01)。术前NDI评分为(60.7±14.2)分,术后3 d降至(35.1±10.1)分,差异有统计学意义(P<0.01)。结论 网袋成形术治疗后壁破裂型颈椎转移性骨折安全、有效,可有效抬高椎体高度,降低治疗风险。

ObjectiveTo discuss the safety and effectiveness of vesselplasty in the treatment of metastatic cervical spine fracture of posterior wall rupture type.MethodsThe clinical data of 26 patients with metastatic cervical spine fracture of posterior wall rupture type,who received vesselplasty therapy,were retrospectively analyzed.The operation success rate,the time spent for operation,the amount of bone cement used,the bone cement leakage,and the procedure-related complications were recorded.The postoperative VAS score and NDI score were compared with the preoperative ones.ResultsSuccessful vesselplasty was accomplished for a total of 27 vertebrae in the 26 patients.The mean time spent for operation was(37.9±11.4)minutes,and the mean used amount of bone cement was(3.1±0.5)mL.Bone cement leakage occurred in four vertebrae(all were asymptomatic leakage),including typeⅠleakage(n=1),typeⅣleakage(n=2),and typeⅤleakage(n=1).The preoperative and the postoperative mean heights of the vertebral body were(0.7±0.2)cm and(1.2±0.3)cm respectively,the difference was statistically significant(P<0.01).The preoperative and the postoperative 3-day mean VAS scores were(7.6±1.3)points and(3.1±1.5)points respectively,the difference was statistically significant(P<0.01).The preoperative and the postoperative 3-day mean neck disability index(NDI)scores were(60.7±14.2)points and(35.1±10.1)points respectively,the difference was statistically significant(P<0.01).ConclusionFor the treatment of metastatic cervical spine fracture of posterior wall rupture type,vesselplasty therapy is clinically safe and effective,it can effectively increase the height of the vertebra and reduce the risk of treatment.