三维导航引导下骨水泥椎体强化椎弓根钉在骨质疏松患者中的应用研究

目的探讨骨质疏松患者应用三维导航引导行骨水泥椎体强化椎弓根钉后椎体固定的临床效果。方法共51例骨质疏松患者,实验组28例于三维导航引导下应用骨水泥行椎弓根钉的椎体强化;对照组23例,术中C型臂X光机监视下应用骨水泥行椎弓根钉的椎体强化。术后2周内复查X线片比较,观察两组患者内固定物有无松动、骨水泥有无渗漏。结果术后所有患者腰痛及下肢神经压迫症状均明显缓解。术后复查X线片实验组均未发现椎弓根螺钉的松动、脱出或骨水泥周围渗漏,仅1例静脉渗漏;对照组患者发现1例螺钉松动,5例骨水泥渗漏;差别有统计学意义。结论三维导航引导下对骨质疏松患者行骨水泥椎体强化椎弓根钉固定,可防止椎弓根钉的松动、脱落,并确保无骨水泥渗漏,是一种理想的脊柱手术方法。

Study on the application of PMMA-reinforced pedicle screws guided by 3D navigation in osteoporosis patients

Objective To explore the clinical effect of poly methylmethacrylate （PMMA）-reinforced pedicle screws guided by 3D navigation on osteoporosis patients. Method Of 51 osteoporosis patients, 28 of the experimental group were treated with PMMA-reinforced pediele screws guided by 3D navigation, while 23 of the control by C-ann X-ray. 2 weeks after operation, pedicle screw loosening and PMMA leakage were monitored by X-ray. Result Symptoms like backache and nerve compression of lower limbs in both groups alleviated obviously after operation. Postoperative X-ray showed： except for 1 venous leakage, no pedicle screw loosening or PMMA leakage were detected in the experimental group, while 1 developed pedicle screw loosening and 5 developed PMMA leakage in the control group （ P 〈 0.05 ）. Conclusion PMMA-reinforced pedicle screws guided by 3D navigation can prevent the pedicle loosening and PMMA leakage for osteoporosis patients, indicating it as an ideal spinal surgery.