主页 > 医学前沿 >
【medical-news】控制性节段球囊扩张椎体后凸成形
调控性节段球囊扩张椎体后凸成形术:一项新技术用于治疗椎体骨密度不均匀的患者
Objective. To describe a novel kyphoplasty procedure that gives uniform bone expansion in treatment of vertebra with heterogeneous bone structure.
目的：描述一种新颖的球囊扩张椎体后凸成形术，可以均匀的扩张骨质结构不均匀的椎体。
Summary of Background Data. Balloon kyphoplasty is used to treat vertebral compression fractures by restoring vertebral height and correcting kyphosis before the injection of bone cement that stabilizes the fracture. In vertebra with heterogeneous bone structure, balloon expansion may be nonuniformly as a result of this heterogeneity and could result in inadequate fracture reduction.
背景资料概述：球囊扩张椎体后凸成形术被用于治疗椎体压缩性骨折，在注射骨水泥稳定骨折之前，需要恢复椎体高度并纠正后凸畸形。对于椎体骨质结构不均匀来说，可能导致球囊不均匀的膨胀，造成骨折复位不充分。
Methods. In the first part of the procedure, the balloon remains partially in its introducer trocar to inflate only the distal segment of balloon in the stronger bone area that provides high mechanical resistance. This segmental inflation creates a cavity that will allow to initiate fracture reduction in the stronger bone area. In the second part of the procedure, the emerging segment is deflated and the balloon is advanced until it emerges completely from the introducer trocar, after which the balloon is inflated totally in the vertebral body. Seven vertebrae in 5 patients (mean age of 71.4 years) were managed with this procedure. Etiology of fractures included myeloma (2 patients, 4 vertebrae) and senile osteoporosis (3 patients, 3 vertebrae). Twenty-millimeter long kyphoplasty balloons were used in all vertebrae. Polymethylmetacrylate bone cement was used to fill the cavities. Technical, anatomic and clinical parameters were used for evaluation of the procedure.
方法：第一步：球囊仍部分留在工作套管内，在强度高、机械阻力大的骨质内膨胀远端部分的球囊，这种节段性膨胀造成一空腔，在骨强度较高的区域完成骨折复位。第一步：将球囊外面的部分抽空，向前送球囊，直至完全露出工作套管，随后在椎体内完全膨胀球囊。按这种方法对5例患者（平均71.4岁）的7节椎体进行手术。骨折的原因包括骨髓瘤（2例患者，4节椎体）、老年性骨质疏松症（3例患者，3节椎体）。所有球囊的长度为20mm。用PMMA骨水泥填充空腔。利用技术、解剖以及临床等参数来评价这项操作。
Results. No complications occurred on balloon inflation. Mean volume of cement injected was 5.8 mL (range, 5-6 mL). Mean maximal inflation pressure was 200 PSI (range, 150-300 PSI). One (14.8%) cement leak was observed at 1 vertebra. Mean restoration of maximal lost height was 42.8% (range, 25%-52.9%). Mean reduction in local kyphosis was 4.4[degrees] (range, 0-10[degrees]). All 5 patients were pain free at 1 month post procedure. Morbidity and mortality were nil.
结果：无球囊扩张的并发症发生。平均注射骨水泥剂量为5.8ml（5-6ml）。平均最大膨胀压力200 PSI（150-300 PSI）。有1例(14.8%)骨水泥渗漏。最大丢失高度平均恢复42.8%（25%-52.9%）。局部后凸畸形平均恢复4.4度（0-10度）。所有患者术后1个月疼痛消失。发病率和死亡率均为零。
Conclusion. The described procedure allows for uniform bone expansion and adequate fracture reduction in vertebrae with heterogeneous bone structure.
结论：这项被描述的手术技术可以在骨质结构不均匀的椎体内使骨质均匀膨胀，使骨折完全复位。 编译
调控性节段球囊扩张椎体后凸成形术:一项新技术用于治疗椎体骨密度不均匀的患者。描述一种新颖的球囊扩张椎体后凸成形术，可以均匀的扩张骨质结构不均匀的椎体。球囊扩张椎体后凸成形术被用于治疗椎体压缩性骨折，在注射骨水泥稳定骨折之前，需要恢复椎体高度并纠正后凸畸形。对于椎体骨质结构不均匀来说，可能导致球囊不均匀的膨胀，造成骨折复位不充分。
第一步：球囊仍部分留在工作套管内，在强度高、机械阻力大的骨质内膨胀远端部分的球囊，这种节段性膨胀造成一空腔，在骨强度较高的区域完成骨折复位。第一步：将球囊外面的部分抽空，向前送球囊，直至完全露出工作套管，随后在椎体内完全膨胀球囊。按这种方法对5例患者（平均71.4岁）的7节椎体进行手术。骨折的原因包括骨髓瘤（2例患者，4节椎体）、老年性骨质疏松症（3例患者，3节椎体）。所有球囊的长度为20mm。用PMMA骨水泥填充空腔。利用技术、解剖以及临床等参数来评价这项操作。无球囊扩张的并发症发生。平均注射骨水泥剂量为5.8ml（5-6ml）。平均最大膨胀压力200 PSI（150-300 PSI）。有1例(14.8%)骨水泥渗漏。最大丢失高度平均恢复42.8%（25%-52.9%）。局部后凸畸形平均恢复4.4度（0-10度）。所有患者术后1个月疼痛消失。发病率和死亡率均为零。这项被描述的手术技术可以在骨质结构不均匀的椎体内使骨质均匀膨胀，使骨折完全复位。
阅读本文的人还阅读：
作者:admin@医学,生命科学 2010-11-14 17:11
医学,生命科学网