摘要
椎体压缩性骨折是骨质疏松最常见的并发症之一。它有相当的发病率,对部分患者造成持续且严重的疼痛。椎体成形术是经皮向骨折塌陷的椎体内注射骨水泥,这种方法已被用来治疗骨质疏松的椎体压缩性骨折,解除患者的疼痛。为介绍该法并探讨安全性和有效性,通过回顾多位作者的报道,我们发现椎体成形术对于疼痛的缓解率可达到67%～100%。短期的并发症主要包括骨水泥的外渗,这不但会增加疼痛,还会散热并压迫脊髓或神经根。合理的选择患者和完善的操作会减低这些并发症,因此,极少需外科减压的手术。但它的长期并发症,如骨水泥-骨接触面的异物反应,骨水泥的老化,由于应力改变而造成相邻椎体骨折的风险增加等尚未完全阐明。因此椎体成形术还需更长时间随访。
Vertebral compression fractures, the most common complication of the osteoporosis, results in significant morbidity of prolonged and intractable pain in some patients. Vertebroplasty procedure that involves percutaneous injection of bone cement into a collapsed vertebra has recently been introduced to treat osteoporotic patients who have prolonged pain following vertebral compression fracture. To determine the details of the procedure and to gather information on its safety and efficacy, we performed a MEDLINE search using the terms ‘vertebroplasty’. We reviewed reports of these procedures in patients with osteoporosis. Several reports suggest that the vertebroplasty is associated with pain relief in 67% to 100% of the cases. Short-term complications, mainly the result of extravasation of cement, can increase pain and damage from heat or compression to the spinal cord or nerve roots. Proper patient selection and good technique can decrease such complications so that the decompression surgery is rarely needed. But long-term complications, which include foreign-body reaction at the cement-bone interface, the wear of the cement, and increased risk of fracture in the adjacent vertebrae due to changes of mechanical stresses, have not been fully evaluated. In short, there is still a long way to go for the vertebroplasty.
出处
《中华创伤骨科杂志》
CAS
CSCD
2004年第7期828-831,共4页
Chinese Journal of Orthopaedic Trauma
关键词
椎体成形术
骨质疏松
椎体骨折
Vertebroplasty
Osteoporosis
Vertebral fractures
