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椎体成形术中与骨水泥渗漏相关的并发症。

Complications related to cement leakage in sacroplasty.

作者信息

Bastian Johannes Dominik, Keel Marius Johann Baptist, Heini Paul Ferdinand, Seidel Ulrich, Benneker Lorin Michael

机构信息

Department of Orthopedic Surgery, University of Bern, Inselspital, Freiburgstrasse 3, 3010 Bern, Switzerland.

出版信息

Acta Orthop Belg. 2012 Feb;78(1):100-5.

Abstract

Data concerning the safety of sacroplasty in terms of cement leakage is scarce. Frequency, distribution patterns and clinical consequences of cement leakage were assessed in 33 patients (28 female, mean age: 74 +/- 10 yrs; bilateral SIF: n = 30, 63 sacroplasties) treated with sacroplasty between 06/2003 and 11/2010 in a retrospective study using patients' records, operative notes and postoperative radiographs. Cement leakage was noted within the fracture gap (27%), into veins (6%), neuroforamina (3%) or in the intervertebral disc space L5/S1 (2%). In one patient, cement leakage into the fracture gap led to unilateral radiculopathy of the 5th lumbar nerve root. Leakage into the fracture gap is at high risk of affecting the 5th lumbar nerve root due to the special course of its ventral branch over the sacral promontory. The risks of cement leakage with neurological impairment should be explained to patients.

摘要

关于椎体成形术在骨水泥渗漏方面安全性的数据很少。在一项回顾性研究中,利用患者记录、手术记录和术后X光片,对2003年6月至2010年11月期间接受椎体成形术治疗的33例患者(28例女性,平均年龄:74±10岁;双侧骶髂关节融合:n = 30,椎体成形术63例)的骨水泥渗漏频率、分布模式及临床后果进行了评估。骨水泥渗漏出现在骨折间隙内(27%)、静脉内(6%)、神经孔内(3%)或L5/S1椎间盘间隙内(2%)。在1例患者中,骨水泥渗漏至骨折间隙导致第5腰神经根单侧神经根病。由于第5腰神经腹侧支在骶骨岬上方的特殊走行,渗漏至骨折间隙有很高风险影响第5腰神经根。应向患者解释骨水泥渗漏伴神经损伤的风险。

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