单侧开口骨水泥推注器在椎体成形术中的应用

doi:10.13418/j.issn.1001-165x.2016.04.023

中国临床解剖学杂志 ›› 2016, Vol. 34 ›› Issue (4): 464-468.doi: 10.13418/j.issn.1001-165x.2016.04.023

单侧开口骨水泥推注器在椎体成形术中的应用

薛厚军，　潘磊，　黄必留，　刘青华，　陈伟雄，　李捷，　王诗成

佛山市第六人民医院脊柱关节外科，广东佛山 528100

收稿日期:2016-03-18 出版日期:2016-07-25 发布日期:2016-08-03
作者简介:薛厚军（1981-），男，安徽庐江人，硕士，主治医师，主要从事脊柱外科方面的研究，Tel：18028123115， E-mail：xuehoujun2000@sina.com
基金资助:
佛山市卫生和计划生育局医学科研立项（2015073）

Application of Single side open bone cement injection device in the operation of percutaneous vertebral plasty

XUE Hou-jun, PAN Lei, HUANG Bi-liu, LIU Qing-hua, CHEN Wei-xiong, LI Jie, WANG Shi-cheng

Department of Spine and Joint Surgery, Foshan Sixth People's Hospital, Foshan 528100, Guangdong Province, China

Received:2016-03-18 Online:2016-07-25 Published:2016-08-03

摘要/Abstract

摘要：

目的　探讨单侧开口骨水泥推注器在经皮穿刺椎体成形术(PVP)中的临床应用。方法　利用单侧侧方开口的骨水泥推注器，一侧经椎弓根建立通道，在DSA透视下沿工作通道将低粘度骨水泥注入椎体内，连续透视并调整开口方向注入骨水泥，治疗骨质疏松性压缩性骨折25例(33椎体), 记录手术时间，骨水泥渗漏及并发症发生情况，术后通过X线片观察骨水泥在椎体内的分布。结果　25例患者随访时间6~12月，平均每节手术时间（27.75±5.29）min，每节注入骨水泥(3.8±0.92)ml，VAS评分术前（7.12±0.78）分、术后3 d（2.2±0.57）分、术后12月（1.44±0.71）分，与术前相比（P<0.01），有显著差异。术中DSA透视及时终止骨水泥渗漏4例，椎体前方及椎间隙渗漏各1例，椎旁渗漏2例，无椎管内渗漏，无神经及血管并发症，无肺栓塞等严重并发症。结论　侧方开口骨水泥推注器可有效改变术中骨水泥的弥散方向，有效控制骨水泥的进一步向外渗漏，通过调节开口方向可通过单侧椎弓根入路达到骨水泥的双侧分布。

关键词: 经皮椎体成形术, 单侧开口骨水泥推注器, 骨质疏松压缩骨折, 单侧入路

Abstract:

Objective　To investigate clinical application of a unilateral opening bone cement injection device in percutaneous vertebral plasty(PVP).　Methods　Using a unilateral opening bone cement injection device, channels were established by the side of the pedicle, and under DSA perspective,low-viscosity vertebral bone cement was introduced into the channel. Continuous injection of bone cement and adjustment of the opening direction under DSA monitoring were performed for osteoporotic compression fractures in 25 cases (33 vertebral bodies). The surgical duration, leakage of bone cement and its complication were recorded; the distribution of bone cement in the vertebral body were observed by X-ray. 　Results　25 patients were followed up for 6~12 months. The average surgical duration was (27.75±5.29) min, each injection of bone cement was (3.8±0.92) ml, VAS score points were (7.12±0.78) preoperatively and (2.2±0.57) 3 d postoperatively, and (1.44±0.71) 12 month spostoperatively. Compared with those before operation significant differences could be detected (P<0.01). Timely termination of 4 cases of bone cement leakage under intraoperative DSA monitoring, 2 cases of leakage in the vertebral body and intervertebral space, and 2 cases of lateral vertebral leakage were observed; no leakage into spinal canal causing nerve and vascular complications, and no serious complications such as pulmonary embolism occurred. Conclusions　Single side open bone cement injection devicecan effectively change the intraoperative dispersion direction of bone cement, effective control of further outward leakage of bone cement. By adjusting the opening direction, bilateral distribution of bone cement can be achieved through unilateral pedicle approach.

Key words: Percutaneous vertebral plasty, Single side open bone cement injection device, Osteoporosis compression fractures, Unilateral approach

薛厚军,潘磊,黄必留,刘青华,陈伟雄,李捷,王诗成. 单侧开口骨水泥推注器在椎体成形术中的应用[J]. 中国临床解剖学杂志, 2016, 34(4): 464-468.

XUE Hou-jun, PAN Lei, HUANG Bi-liu, LIU Qing-hua, CHEN Wei-xiong, LI Jie, WANG Shi-cheng. Application of Single side open bone cement injection device in the operation of percutaneous vertebral plasty[J]. Chinese Journal Of Clinical Anatomy, 2016, 34(4): 464-468.

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单侧开口骨水泥推注器在椎体成形术中的应用

Application of Single side open bone cement injection device in the operation of percutaneous vertebral plasty

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