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经皮椎体后凸成形术患者骨水泥相关并发症的预防与治疗

Prevention and treatment of bone cement-related complications in patients receiving percutaneous kyphoplasty.

作者信息

Zhang Kaining, Shen Yingchun, Ren Yanjun, Zou Debo

机构信息

Department of Spine Surgery, Shandong Provincial Qianfoshan Hospital Jinan 250014, P.R. China.

Department of Surgery, Juye County Beicheng Hospital Heze 274900, P. R. China.

出版信息

Int J Clin Exp Med. 2015 Feb 15;8(2):2371-7. eCollection 2015.

PMID:25932175
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4402822/
Abstract

OBJECTIVE

This study is to investigate the complications and preventive measures of bone cement in percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures.

METHODS

A retrospective analysis of 134 cases of osteoporotic vertebral compression fracture patients treated with percutaneous kyphoplasty, which involved 182 vertebral fractures, was performed. The bone cement-related complications, the reasons causing these complications, and the preventive measures were investigated.

RESULTS

Successful operation was performed in all patients. Operative bone cement toxic reaction occurred in 1 patient. Different degrees of leakage of bone cement were found in 21 patients with 25 fractures and 1 case needed operation treatment. During the long term follow-up, bone necrosis absorption and cement drifted away which needed operation treatment was found in 1 patient with vertebral fracture. Thirteen adjacent vertebral fractures were found in 11 patients and 10 patients underwent operation treatment again.

CONCLUSIONS

With careful surgery, complications associated with bone cement could be greatly reduced.

摘要

目的

本研究旨在探讨经皮椎体后凸成形术中骨水泥治疗骨质疏松性椎体压缩骨折的并发症及预防措施。

方法

对134例接受经皮椎体后凸成形术治疗的骨质疏松性椎体压缩骨折患者进行回顾性分析,共涉及182处椎体骨折。调查与骨水泥相关的并发症、导致这些并发症的原因及预防措施。

结果

所有患者手术均成功。1例患者发生术中骨水泥毒性反应。21例患者25处骨折出现不同程度的骨水泥渗漏,1例需要手术治疗。长期随访期间,1例椎体骨折患者出现骨坏死吸收及骨水泥移位,需要手术治疗。11例患者出现13处相邻椎体骨折,10例患者再次接受手术治疗。

结论

通过仔细手术,可大幅减少与骨水泥相关的并发症。

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本文引用的文献

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[Kyphoplasty in the treatment of osteoporotic spine fractures - experience with 1069 cases].[椎体后凸成形术治疗骨质疏松性脊柱骨折——1069例经验]
Z Orthop Unfall. 2014 Aug;152(4):315-8. doi: 10.1055/s-0034-1368448. Epub 2014 Aug 21.
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Balloon kyphoplasty for osteoporotic spinal fractures with middle column compromise.球囊后凸成形术治疗伴有中柱受损的骨质疏松性脊柱骨折。
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A prospective study of percutaneous balloon kyphoplasty with calcium phosphate cement in traumatic vertebral fractures: 10-year results.磷酸钙骨水泥经皮球囊椎体后凸成形术治疗创伤性椎体骨折的前瞻性研究:10年结果
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Comparison of radiological and clinical results of balloon kyphoplasty according to anterior height loss in the osteoporotic vertebral fracture.根据骨质疏松性椎体骨折的前柱高度丢失情况比较球囊扩张椎体后凸成形术的影像学和临床结果。
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Spine J. 2014 Sep 1;14(9):2063-77. doi: 10.1016/j.spinee.2013.12.019. Epub 2013 Dec 27.
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Cement directed kyphoplasty reduces cement leakage as compared with vertebroplasty: results of a controlled, randomized trial.水泥导向性经皮椎体后凸成形术相较于经皮椎体成形术可减少骨水泥渗漏:一项对照、随机试验的结果。
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Cement leakage as a possible complication of balloon kyphoplasty--is there a difference between osteoporotic compression fractures (AO type A1) and incomplete burst fractures (AO type A3.1)?骨水泥渗漏作为球囊扩张椎体后凸成形术的一种可能并发症——在骨质疏松性压缩骨折(AO 分型 A1)和不完整爆裂骨折(AO 分型 A3.1)之间是否存在差异?
Acta Neurochir (Wien). 2012 Feb;154(2):313-9. doi: 10.1007/s00701-011-1239-3. Epub 2011 Dec 8.
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Vertebral body recollapse without trauma after kyphoplasty with calcium phosphate cement.磷酸钙骨水泥椎体后凸成形术后无外伤情况下椎体再塌陷
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[Balloon kyphoplasty in the treatment of osteoporotic vertebral fractures: indications - treatment strategy - complications].[球囊椎体后凸成形术治疗骨质疏松性椎体骨折:适应症 - 治疗策略 - 并发症]
Z Orthop Unfall. 2010 Dec;148(6):646-56. doi: 10.1055/s-0030-1250379. Epub 2010 Nov 15.
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