椎基静脉孔与椎体内裂隙相通可能是PKP骨水泥渗漏的潜在危险因素

发布时间：2018-02-24 16:39

本文关键词： 椎内裂隙征椎基静脉孔经皮球囊后凸成形术骨水泥漏骨质疏松性椎体压缩骨折　出处：《浙江大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的：通过对伴与不伴椎内裂隙征的椎体行经皮椎体后凸成形术(PKP)后不同类型骨水泥渗漏的发生率的评估,探讨椎基静脉孔和椎内裂隙相通是否为骨水泥渗漏的危险因素。材料与方法：回顾性分析2009年1月至2013年1月我科行PKP手术的224位患者的270个手术椎体术前与术后平片、CT及MRI。所有病例依据是否存在椎体内裂隙分为裂隙组和骨小梁组。将骨水泥渗漏分为5型：通过骨皮质缺损进入椎旁软组织(A型)；通过椎基静脉孔(B型)；通过进针管道(c型)；通过骨皮质缺损进入椎间盘区域(D型)；以及通过椎旁静脉(E型)。分别统计两组各类型的骨水泥渗漏的发生率并分析是否存在统计学差异。结果：裂隙组72例,骨小梁组198例。B型骨水泥渗漏最为常见,占总手术椎体的15.5%(42例),其次为D型骨水泥漏(7.8%,21例)。裂隙组B型骨水泥渗漏发生率为23.6%高于骨小梁组12.6%,且两者之间有统计学意义(p=0.028)。其余各型骨水泥渗漏之间无统计学差异。结论：B型骨水泥渗漏在伴椎内裂隙征的椎体中更为常见,说明椎内裂隙征和椎基静脉孔之间存在通道。因此在伴椎内裂隙征的椎体行PKP手术时,需特别小心避免骨水泥通过椎基静脉孔漏入椎管。
[Abstract]:Objective: to evaluate the incidence of different types of bone cement leakage after percutaneous kyphoplasty (PKP) in vertebrae with and without intravertebral fissure sign, and to explore whether the connection between vertebral basal foramen and intravertebral fissure is a risk factor for bone cement leakage. Materials and methods: from January 2009 to January 2013, 270 patients who underwent PKP operation were analyzed retrospectively. Ct and MRIs were performed before and after operation. All cases were divided into two groups according to the existence of intravertebral fissure. Bone trabeculae group. Bone cement leakage is divided into 5 types: through cortical defect into paravertebral soft tissue type A; through vertebrobasilar vein foramen B; through needle tube to type c; through bone cortical defect into intervertebral disc area; type D; through bone cortical defect into the region of intervertebral disc. The incidence of bone cement leakage in the two groups was counted and the statistical difference was analyzed between the two groups through the E type of paravertebral vein. Results: there were 72 cases in fracture group and 198 cases in trabecular bone group. The incidence of type B cement leakage in the fracture group was 23.6% higher than that in the trabecular bone trabeculae group (12.6%), and there was statistical significance between the two groups. There was no significant difference between the other types of bone cement leakage. Conclusion the leakage of bone cement type B is more common in the vertebral body with intravertebral fissure sign, indicating that there is a passage between the fissure sign and the foramen of vertebral base. Therefore, in the PKP operation of vertebral body with intravertebral fissure sign, Special care should be taken to prevent bone cement from leaking into the spinal canal through the foramen vertebrae.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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