Abstract：Objective To explore the clinical efficacy of cement extravasation prevention by artificial bone graft combined with the two balloon dilation for the treatment of osteoporotic vertebral compression fractures.Methods Clinical data of 60 cases with osteoporotic thoracolumbar vertebral compression fracture treated by the unilateral pedicle puncture percutaneous kyphoplasty (PKP) were retrospectively analyzed, including 15 cases( T11 3 cases, T12 3 cases, L1 5 cases, L2 2 cases, L4 1 case, L5 1 case) of contrast agent extravasation found in operation. The artificial bone was pressed into powder and tuned into a thick paste; the thick paste was injected into the vertebral body by the injector. After the second balloon dilatation, bone cement like toothpaste was injected into the vertebral body slowly in X-ray fluoroscopy. Postoperative bone cement extravasation and kyphosis Cobb angle as well as visual analogue scale (VAS) score improvement were observed. According to the degree of pain reliesing evaluate the clinical curative effect.Results All 15 patients were completed the operation. The third day after the operation, the review X-ray showed a good recovery of vertebral height of each disease, the vertebral bone cement filling was good, evenly distributed, without intervertebral, paraspinal or spinal bone cement extravasation. The average Cobb angle of kyphosis was corrected 10.1°±2.4°, and the average VAS score was reduced by 6.2±0.2. Compared with preoperation, the differences were statistically significant (tCobb=16.299, tVAS=120.062, all P values<0.01). Fifteen cases were followed up for 4 weeks to 24 weeks, with an average of 19 weeks. The fourth week of the postoperative, X-ray showed that no significant vertebral height of each disease was missing, no new adjacent vertebral fracture was found. The efficacy was evaluated the fourth week after surgery, the symptoms of pain was disappeared or obviously improved, and the patients could walk normally. Among them, 2 cases were excellent, 13 cases were good.Conclusions Artificial bone graft combined with the two balloon dilation is effective for cement extravasation prevention in the treatment of osteoporotic thoracolumbar compression fracture by PKP balloon dilation, but the postoperative clinical efficacy needs further observation.
陶学顺,余润泽,张长春,沈政,曹参. 人工植骨结合二次球囊扩张在椎体后凸成形术中骨水泥外渗中的临床应用[J]. 中华解剖与临床杂志, 2014, 19(3): 224-227.
Tao Xueshun, Yu Runze, Zhang Changchun, Shen Zheng, Cao Shen. Clinical application of artificial bone graft combined with the two balloon dilation in prevention of cement extravasation in percutaneous kyphoplasty. Chinese Journal of Anatomy and Clinics, 2014, 19(3): 224-227.
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