经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的并发症分析

Analysis of complications of kyphoplasty for osteoporotic vertebral compression fractures

中文关键词:  经皮椎体后凸成形术  骨质疏松  椎体压缩骨折  并发症  预防

英文关键词:Percutaneous vertebral kyphoplasty  Osteoporotic  Vertebral compression fractures  Complications  Prevention

中文摘要:

  【摘要】 目的：总结经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures，OVCFs）的并发症，探讨其发生原因及其预防措施。方法：2004年9月~2009年6月，采用PKP治疗OVCFs患者115例，男24例，女91例，年龄52～83岁，平均68岁；单椎体83例，双椎体24例，3椎体5例，4椎体2例，5椎体1例；术前均由MRI STIR序列确定伤椎节段，T6 1个，T7 2个，T8 2个，T9 8个，T10 9个，T11 24个，T12 44个，L1 41个，L2 18个，L3 5个，L4 3个，L5 2个。回顾总结其并发症发生情况，分析其并发症的发生原因。结果：115例患者中21例发生并发症，发生率为18.2%。其中骨水泥渗漏13例（11.3%），术中球囊破裂3例（2.6%），穿刺入椎管2例（1.7%），取出球囊病椎高度丢失2例（1.7%），术后病椎塌陷1例（0.9%），均无严重神经损害，未出现感染、硬膜外血肿及肺栓塞等并发症。结论：PKP治疗OVCFs常见的并发症包括骨水泥渗漏、球囊破裂、穿刺入椎管、术中病椎高度丢失、术后病椎再塌陷等，术中及术后应采取相应的防范措施，预防或减少并发症的发生。

英文摘要:

  【Abstract】 Objectives: To Summarize the complications of percutaneous kyphoplasty(PKP) for osteoporotic vertebral compression fractures(OVCFs), and to investigate its causes and prevention. Methods: From September 2004 to June 2009, the PKP was performed on 115 OVCFs patients. There were 24 males and 91 females, with an average age of 68 years(range, 52-83 years). 83 cases had single vertebra, 24 cases had double vertebrae, 5 cases had 3 vertebrae, 2 cases had 4 vertebrae, 1 case had 5 vertebrae involved. Preoperative MRI STIR sequence was used to determine injured segment, including 1 in T6, 2 in T7, 2 in T8, 8 in T9, 9 in T10, 24 in T11, 44 in T12, 41 in L1, 18 in L2, 5 in L3, 3 in L4, 2 in L5. The complications and causes were analyzed. Results: A total of 21 cases was noted complications, with the rate of occurrence of 18.2%. Bone cement leakage was noted in 13 cases(11.3%); intraoperative balloon rupture in 3 cases(2.6%); perforation into the spinal canal in 2 cases(1.7%); loss of height in 2 cases(1.7%); postoperative vertebral collapse 1 cases(0.9%). No severe neurological deficit, epidural hematoma or pulmonary embolism was noted. Conclusions: The complications associated with PKP treatment include bone cement leakage, balloon rupture, perforation into the spinal canal, vertebral height loss, postoperative vertebral collapse, which should be managed by corresponding preventions.