首页|骨质疏松椎体骨折单侧椎弓根外经皮后凸成形术

骨质疏松椎体骨折单侧椎弓根外经皮后凸成形术

Unilateral extrapedicular percutaneous kyphoplasty for osteoporotic vertebral compression fracture

扫码查看
[目的]介绍单侧经椎弓根外入路经皮后凸成形术治疗骨质疏松椎体骨折的手术操作技术和初步临床疗效.[方法]对26例骨质疏松椎体骨折患者,行单侧经椎弓根外入路经皮后凸成形术.穿刺针沿穿刺点向椎弓根外缘逐步穿刺,调整穿刺针,透视正位像上穿刺针尖位于椎弓根外缘,侧位像穿刺针尖位于椎弓根中线,平行于上终板进针约1 cm.置入环锯,旋入约2cm后取出,沿穿刺工作套管置入球囊,缓慢扩张球囊至塌陷椎体高度恢复,撤出球囊,用骨水泥注入器在透视下低压将骨水泥推入椎体,进行椎体填充.[结果]26例患者均顺利完成手术,其中骨水泥渗漏1例,切口红肿感染1例,皮缘坏死2例,切口血肿3例.随访时间6个月~3年,所有患者疼痛均明显缓解,恢复日常生活活动能力;仅2例发现其他椎体新发骨折外,再次给予PKP治疗,恢复满意.所有患者均未发生死亡或其他严重并发症.[结论]单侧经椎弓根外入路经皮后凸成形术治疗骨质疏松椎体骨折,操作可行,可缩短手术时间,疗效可靠.
[Objective]To introduce the surgical technique and preliminary clinical outcomes of unilateral extrapedicular percutaneous kyphoplasty(PKP)for the treatment of osteoporotic vertebral compression fractures(OVCF).[Methods]A total of 26 patients received uni-lateral extrapedicular percutaneous kyphoplasty for OVCF.The puncture needle was gradually punctured along the puncture point to the out-er edge of the pedicle,and the puncture needle was adjusted.As puncture needle tip was located at the outer edge of the pedicle on the an-teroposterior(AP)image,and the needle tip was adjusted to locate at the median line of the pedicle on the lateral image,then the needle was inserted about 1 cm parallel to the upper endplate.Subsequently,a trephine was inserted and advanced about 2 cm before removed.A bal-loon was placed along the puncture working cannula,then was slowly expanded to recover at the height of the collapsed vertebral body.After the balloon was withdrawn,and the bone cement injector was used to push the bone cement into the vertebral body at low pressure with cau-tion until the vertebral body was filled.[Results]All the 26 patients had the extrapedicular PKP performed successfully with 1 case of bone cement leakage,1 case of knife edge infection,2 cases of skin edge necrosis,3 cases of knife edge hematoma.Follow-up period lasted from 6 months to 3 years,with an average of 1.6 years.All patients got significant pain relief and regain daily life activity capacity,except 2 cases who were found new onset of fractures in other vertebrae,were given PKP again and got satisfactory recovery.No death or other serious com-plications occurred in anyone of them.[Conclusion]Unilateral extrapedicular percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures is feasible with shortened operation time and reliable outcomes.

osteoporotic vertebral compression fractureextrapedicular approachpercutaneous kyphoplasty

袁延胜、苏保辉、栾素娴

展开 >

潍坊滨海经济技术开发区人民医院骨科,山东潍坊 262737

潍坊市人民医院骨科,山东潍坊 261041

骨质疏松性椎体压缩骨折 经椎弓根外入路 经皮后凸成形术

潍坊市卫生健康委科研项目

wfwsjk_2019_002

2024

中国矫形外科杂志
中国残疾人康复协会 中国人民解放军第八十八医院

中国矫形外科杂志

CSTPCD北大核心
影响因子:1.521
ISSN:1005-8478
年,卷(期):2024.32(5)
  • 17