Heo Dong Hwa, Cho Sung Min, Cho Yong Jun, Cho Jun Hyeung, Sheen Seung Hun
Department of Neurosurgery, Chunchon Sacred Heart Hospital, Hallym University College of Medicine, Chunchon-shi, Kangwon-do, South Korea.
World Neurosurg. 2010 Mar;73(3):207-9; discussion e35. doi: 10.1016/j.surneu.2009.07.038. Epub 2009 Oct 13.
Recently, calcium phosphate (CaP) cement, instead of polymethylmethacrylate, has been injected into the compressed vertebral body. Calcium phosphate may have the potential for ectopic or heterotopic ossification and, thus, injected CaP cement can induce unwanted heterotopic ossifications in the human body.
The authors describe 2 cases of heterotopic ossifications after vertebroplasty using CaP in osteoporotic vertebral compression fractures. We performed percutaneous vertebroplasty using CaP cement in a 69-year-old woman with L2 compression fracture and an 80-year-old man with L1 compression fracture. Follow-up radiologic studies for both cases showed that heterotopic ossifications had developed around the CaP-augmented vertebral bodies and that the cemented vertebral bodies had recollapsed. Also, subsequent vertebral compression fractures had occurred.
We suggest that heterotopic ossification may be complications of vertebroplasty with CaP. Therefore, we strongly recommended that the patients who undergo a vertebroplasty with CaP need strict observation.
近来,磷酸钙(CaP)骨水泥已被用于注入压缩椎体,而非聚甲基丙烯酸甲酯。磷酸钙可能具有异位或异常骨化的可能性,因此,注入的CaP骨水泥可在人体内诱发不必要的异位骨化。
作者描述了2例在骨质疏松性椎体压缩骨折中使用CaP进行椎体成形术后发生异位骨化的病例。我们对一名L2压缩骨折的69岁女性和一名L1压缩骨折的80岁男性使用CaP骨水泥进行了经皮椎体成形术。对这两例病例的随访影像学研究显示,在CaP强化的椎体周围出现了异位骨化,且骨水泥强化的椎体再次塌陷。此外,随后还发生了椎体压缩骨折。
我们认为异位骨化可能是CaP椎体成形术的并发症。因此,我们强烈建议接受CaP椎体成形术的患者需要严格观察。