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经皮椎体成形术和经皮后凸成形术的现状——综述。

Current status of percutaneous vertebroplasty and percutaneous kyphoplasty--a review.

机构信息

Department of Orthopedics, The First Affiliated Hospital of Medical College of Xian Jiaotong University, Xi'an, Shaanxi, China.

出版信息

Med Sci Monit. 2013 Oct 7;19:826-36. doi: 10.12659/MSM.889479.

Abstract

Percutaneous vertebroplasty (PV) and kyphoplasty (PK) are the 2vertebral augmentation procedures that have emerged as minimally invasive surgical options to treat painful vertebral compression fractures (VCF) during the last 2 decades. VCF may either be osteoporotic or tumor-associated. Two hundred million women are affected by osteoporosis globally. Vertebral fracture may result in acute pain around the fracture site, loss of vertebral height due to vertebral collapse, spinal instability, and kyphotic deformity. The main goal of the PV and PK procedures is to give immediate pain relief to patients and restore the vertebral height lost due to fracture. In percutaneous vertebroplasty, bone cement is injected through a minimal incision into the fractured site. Kyphoplasty involves insertion of a balloon into the fractured site, followed by inflation-deflation to create a cavity into which the filler material is injected, and the balloon is taken out prior to cement injection. This literature review presents a qualitative overview on the current status of vertebral augmentation procedures,especially PV and PK, and compares the efficacy and safety of these 2 procedures. The review consists of a brief history of the development of these 2 techniques, a discussion on the current research on the bone cement, clinical outcome of the 2 procedures, and it also sheds light on ongoing and future research to maximize the efficacy and safety of vertebral augmentation procedures.

摘要

经皮椎体成形术(PV)和椎体后凸成形术(PK)是过去 20 年来出现的两种微创脊柱增强手术,用于治疗疼痛性椎体压缩性骨折(VCF)。VCF 可能与骨质疏松症或肿瘤有关。全球有 2 亿女性受到骨质疏松症的影响。椎体骨折可能导致骨折部位周围出现急性疼痛、椎体塌陷导致椎体高度丢失、脊柱不稳定和脊柱后凸畸形。PV 和 PK 手术的主要目的是为患者提供即时的疼痛缓解,并恢复因骨折而丢失的椎体高度。在经皮椎体成形术中,通过微小切口将骨水泥注入骨折部位。椎体后凸成形术涉及将球囊插入骨折部位,然后进行充气-放气以在其中创建一个空腔,将填充物注入其中,然后在注入骨水泥之前将球囊取出。本文综述了目前椎体增强手术的现状,特别是 PV 和 PK,并比较了这两种手术的疗效和安全性。综述包括这两种技术发展的简要历史、对骨水泥的当前研究的讨论、两种手术的临床结果,以及对正在进行和未来的研究的探讨,以最大限度地提高椎体增强手术的疗效和安全性。

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