注射型磷酸钙人工骨椎体后凸成形固化治疗骨质疏松性胸腰椎压缩骨折

背景：椎体后凸成形目前常用的注射型聚甲基丙烯酸甲酯骨水泥椎体增强剂可达到增加椎体强度、稳定椎体、止痛的目的,但其组织相容性差,无生物降解性,容易造成使临近椎间盘或椎体发生变性、甚至骨折。目的：观察注射型磷酸钙人工骨椎体后凸成形固化治疗骨质疏松性椎体压缩骨折的效果。方法：选择2007-12/2010-06哈尔滨医科大学附属第四医院骨外科收治的骨质疏松性胸腰椎压缩性骨折患者20例,均采用经双侧椎弓根球囊扩张注射型磷酸钙人工骨行椎体后凸成形固化治疗。手术前后行疼痛目测类比评分,胸（腰）椎正侧位X射线片及椎体前缘高度、Cobb角检测。结果与结论：术后病椎前缘椎体平均高度较术前平均高度恢复（3.38±1.44）mm（P〈0.05）。术后Cobb角较术前平均恢复（7.63±2.52）°（P〈0.05）,后凸矫正率为（38.90±11.28）%。术后3d及3周目测类比评分均较术前明显降低（P〈0.01）。说明经双侧椎弓根球囊扩张注射型磷酸钙人工骨行椎体后凸成形可以有效增加椎体强度、稳定椎体、明显缓解患者疼痛,是治疗骨质疏松性胸腰椎压缩骨折的有效方法。

Treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty by calcium phosphate cement

BACKGROUND：Injectable polymethylmethacrylate（PMMA） with percutaneous kyphoplasty can increase vertebral strength,stabilize vertebral body,relieve pain,but its histocompatibility is poor with no biodegradability,which is easy to cause adjacent or vertebral body denaturation,even fractures. OBJECTIVE：To observe the clinical effect of percutaneous kyphoplasty by calcium phosphate cement on osteoporotic vertebral compression fractures. METHODS：Twenty cases of osteoporotic vertebral compression fractures were selected from the Fourth Affiliated Hospital of Harbin Medical University from 2007-12 to 2010-06. All cases were treated with injected calcium phosphate cement with percutaneoue kyphoplasty by bilateral transpedicular balloon approach. Preoperative and postoperative visual analog scale（VAS） score,X-ray,Cobb＇s angle,variation of vertebral body height were measured. RESULTS AND CONCLUSION：Average recovery height of the vertebral body was（3.38±1.44） mm（P 0.05） . The Cobb＇s angle average recovery was（7.63± 2.52） °（P 0.05） . The restorations of kyphosis was（38.9±11.28） %. Preoperative VAS score was higher than that postoperative 3 days and 3 weeks（P 0.01） . Percutaneous kyphoplasty with injected calcium phosphate cement can effectively relieve the pain and treat osteoporotic vertebral compression fractures.