椎体成形术在颈椎骨质疏松椎体内固定中的应用

目的探讨椎体成形术强化骨质疏松颈椎椎体内固定的有效性及安全性。方法16例颈椎疾患中，脊髓型颈椎病13例，颈椎结核2例，无骨折脱位型颈脊髓损伤1例。16例经骨密度检测确定合并重度骨质疏松症。常规前路病灶清除、减压植骨，于上、下位拟行固定的椎体在直视下注射骨水泥，上钢板螺钉固定。观察骨水泥注射剂量、骨水泥渗漏、内固定牢靠、植骨融合、神经功能恢复等情况。结果16例患者手术顺利完成，每椎体骨水泥注射剂量1．5～2ml，平均1．65ml，骨水泥静脉渗漏1例。随访6～18个月，平均11个月，颈椎内固定钢板螺钉无松动，植骨块无移位。13例如期愈合，3例延迟融合，神经功能：Frankel分级进步1—2级。结论椎体成形可强化颈椎骨质疏松椎体，防止内固定松动，利于植骨融合。掌握骨水泥注射技术，可预防骨水泥渗漏，提高安全性。

Clinical Application of Vertebroplasty in Cervical Vertebral Osteoporosis Internal Fixation

Objective To investigate the effectiveness and safety of vertebroplasty in osteoporotie cervical vertebral fixation. Methods Of 16 eases, 13 cases cervical spondylotie myelopathy, 2 eases cervical vertebral tuberculosis, 1 ease non-fracture cervical dislocation with spinal cord injury, were confirmed with serious osteoporosis by bone mineral density detector. Conventional anterior debridement, decompression and bone graft,injected bone cement with direct vision in the upper and lower vertebras which were ready to be fixed, fix vertebra with plate and screws. Observe bone cement injection dose, bone cement leakage, solid internal fixation, bone fusion, nerve function,etc. Results 16 cases were successfully completed, bone cement injection dose for every vertebra was 1.5 ml to 2 ml, average 1.65 ml, 1 case with bone cement leakage. Follow-up period from 6 months to 18 months, average 11 months, cervical plate and screw fixation without loosening,bone block without displacement, bone healing as schedule happened in 13 cases ,while the other 3 cases were healing delayed. Nerve function in all eases was improved 1 - 2 degree according to Frankel degree. Conclusion Vertebroplasty could strengthen cervical vertebral with osteoporosis, prevent internal fixation loosening, and is favor of bone graft fusion. If doctors master bone cement injection technology, they could prevent bone cement leakage and improve safety.