OVCF手术中骨水泥的研究进展及应用展望
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摘要
随着我国逐步进入老龄化社会,近年来老年人骨质疏松性椎体压缩骨折呈上升趋势。骨质疏松性椎体压缩性骨析的治疗历经保守、开放手术,如今已发展到微创手术阶段,可用的治疗方案包括经皮椎体成形术和经皮椎体后凸成形术,具有创伤小、解除疼痛效果好、并发症低等特点。在这两种手术中骨水泥的应用具有重大的意义,不仅能有效地恢复椎体高度、减轻患者疼痛,而且还可产生巨大的经济和社会效益。本文针对骨水泥的相关研究和临床实践做一简单综述与展望。
With China gradually entering the aging society in recent years, the increasing osteoporotic vertebra compression fractures occurs in the elderly. After the conservative and open surgery, the treatment of OVCF has evolved into minimally invasive surgical procedures, which mainly include percutaneous vertebroplasty and percutaneous kyphoplasty. Obviously, they can facilitate a less trauma, pain relief, and low complication. Bone cement plays an important role in the two operations on account of both the recovery of vertebral height and subsequent pain relief and its great economic and social benefits. Therefore, this research on bone cement was introduced to guide the clinical practice in this paper.
With China gradually entering the aging society in recent years, the increasing osteoporotic vertebra compression fractures occurs in the elderly. After the conservative and open surgery, the treatment of OVCF has evolved into minimally invasive surgical procedures, which mainly include percutaneous vertebroplasty and percutaneous kyphoplasty. Obviously, they can facilitate a less trauma, pain relief, and low complication. Bone cement plays an important role in the two operations on account of both the recovery of vertebral height and subsequent pain relief and its great economic and social benefits. Therefore, this research on bone cement was introduced to guide the clinical practice in this paper.
引文
[1]李伟,盛炎炎.骨质疏松椎体压缩性骨折治疗进展[J].中医药临床杂志,2014,26(10):1102-1104.
[2]Yuan WH,Hsu HC,Lai KL.Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures:a meta-analysis[J].Medicine(Baltimore),2016,95(31):e4491.
[3]包拥政,祝周兴,冯云升,等.低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响:三维有限元分析[J].中国组织工程研究,2016,20(16):2285-2293.
[4]Murphy KJ,Deramond H.Percutaneous vertebroplasty in benign and malignant disease[J].Neuroimaging Clin N Am,2000,10(3):535-545.
[5]白明,银和平,吴一民,等.骨水泥复合人工骨修复材料在经皮穿刺球囊扩张椎体后凸成形术中的应用[J].中国矫形外科杂志,2016,24(22):2022-2026.
[6]Cho AR,Kim HK,Kwon JY,et al.The incorporation of platelet-rich plasma into calcium phosphate cement en hances bone regeneration in osteoporosis[J].Pain Physician,2014,17(6):E737-E745.
[7]陶晖,张超,仇志烨,等.骨质疏松椎体压缩性骨折可注射骨水泥研究进展[J].转化医学杂志,2013,2(5):310-313.
[8]Perovi'c D,Bori'c I.Diagnostics and treament of osteoporotic vetebral fractures[J].Reumatizam,2014,61(2):75-79.
[9]Zhang L,Wang Q,Wang L,et al.Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures[J].Clin Interv Aging,2017,12:431-436.
[10]陈建常,马在松,陈文红,等.骨水泥分布形态对骨质疏松性椎体压缩性骨折手术效果影响[J].解放军医药杂志,2015,27(5):82-85.
[11]简志训,陈政行,林建宇,等.椎体成形术中不同骨水泥容量及位置的生物力学评估[J].中华创伤骨科杂志,2005,7(10):903-907.
[12]周炳荣,张杰,朱建平,等.PKP球囊扩张体积对骨水泥注射剂量及邻椎再骨折的影响[J].江苏医药,2016,42(15):1713-1715.
[13]Staples MP,Howe BM,Ringler MD,et al.New vertebral fractures after vertebroplasty:2-year results from a randomised controlled trial[J].Arch Osteoporos,2015,10:229.
[14]Ota K,Iwasaki S.Vertebral bone drilling(puncture)attenuates the acute pain due to vertebral compression fractures[J].Open J Anesthesiol,2014,4(2):46-49.
[15]梅贤忠,刘修华,甘学文,等.椎体成形术中高粘度骨水泥与普通骨水泥渗漏的比较[J].中国中医骨伤科杂志,2017,25(6):57-60.
[16]郭永贤,宋世江,乔培柳,等.高黏度骨水泥经皮椎体成形术联合仙灵骨葆胶囊治疗骨质疏松性椎体压缩性骨折的临床研究[J].中国医药导报,2016,13(24):93-96.
[17]李建赤,黄必留,谭加群,等.高黏度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床研究[J].中国骨与关节外科,2016,9(4):317-321.
[18]笪晓伟,李启中,区杰雄,等.高黏度与低黏度骨水泥在经皮椎体后凸成形术中的应用比较[J].中国骨科临床与基础研究杂志,2015,7(2):79-83.
[19]杨惠林,王根林,姜为民,等.分次灌注骨水泥技术治疗Kümmell病[J].脊柱外科杂志,2012,10(1):22-24.
[20]曾逸文,许建安.经皮椎体成形中的骨水泥分期注射[J].中国组织工程研究,2013,17(12):2117-2122.
[21]Guo D,Cai J,Zhang S,et al.Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilat eral percutaneous vertebroplasty[J].Medicine(Baltimore),2017,96(14):e6549.
[22]Stevenson M,Gomersall T,Lloyd JM,et al.Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures:a systematic review and cost-effectiveness analysis[J].Health Technol Assess,2014,18(17):1-290.
[23]Ha KY,Kim YH,Yoo SR,et al.Bone cement dislodgement:one of complications following bone cement augmentation procedures for osteoporotic spinal fracture[J].J Korean Neurosurg Soc,2015,57(5):367-370.
[24]Kwon HM,Lee SP,Baek JW,et al.Appropriate cement volume in vertebroplasty:a multivariate analysis with short-term follow-up[J].Korean J Neurotrauma,2016,12(2):128-134.
[25]江晓兵,黄宏伟,张顺聪,等.经皮椎体强化术中骨水泥渗漏与否对患者凝血功能变化的影响[J].中华临床医师杂志:电子版,2013,7(3):996-999.
[26]刘昊,迮骁,邹俊,等.经皮椎体后凸成形术的骨水泥分布与临床疗效分析[J].中华骨与关节外科杂志,2017,10(1):8-12.
[27]Zhang K,Shen Y,Ren Y,et al.Prevention and treatment of bone cement-related complications in patients receiv ing percutaneous kyphoplasty[J].Int J Clin Exp Med,2015,8(2):2371-2377.
[28]Health Quality Ontario.Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures:a systematic review[J].Ont Health Technol Assess Ser,2016,16(11):1-202.
[2]Yuan WH,Hsu HC,Lai KL.Vertebroplasty and balloon kyphoplasty versus conservative treatment for osteoporotic vertebral compression fractures:a meta-analysis[J].Medicine(Baltimore),2016,95(31):e4491.
[3]包拥政,祝周兴,冯云升,等.低弹性模量骨水泥对骨质疏松压缩性骨折椎体及邻近椎体应力的影响:三维有限元分析[J].中国组织工程研究,2016,20(16):2285-2293.
[4]Murphy KJ,Deramond H.Percutaneous vertebroplasty in benign and malignant disease[J].Neuroimaging Clin N Am,2000,10(3):535-545.
[5]白明,银和平,吴一民,等.骨水泥复合人工骨修复材料在经皮穿刺球囊扩张椎体后凸成形术中的应用[J].中国矫形外科杂志,2016,24(22):2022-2026.
[6]Cho AR,Kim HK,Kwon JY,et al.The incorporation of platelet-rich plasma into calcium phosphate cement en hances bone regeneration in osteoporosis[J].Pain Physician,2014,17(6):E737-E745.
[7]陶晖,张超,仇志烨,等.骨质疏松椎体压缩性骨折可注射骨水泥研究进展[J].转化医学杂志,2013,2(5):310-313.
[8]Perovi'c D,Bori'c I.Diagnostics and treament of osteoporotic vetebral fractures[J].Reumatizam,2014,61(2):75-79.
[9]Zhang L,Wang Q,Wang L,et al.Bone cement distribution in the vertebral body affects chances of recompression after percutaneous vertebroplasty treatment in elderly patients with osteoporotic vertebral compression fractures[J].Clin Interv Aging,2017,12:431-436.
[10]陈建常,马在松,陈文红,等.骨水泥分布形态对骨质疏松性椎体压缩性骨折手术效果影响[J].解放军医药杂志,2015,27(5):82-85.
[11]简志训,陈政行,林建宇,等.椎体成形术中不同骨水泥容量及位置的生物力学评估[J].中华创伤骨科杂志,2005,7(10):903-907.
[12]周炳荣,张杰,朱建平,等.PKP球囊扩张体积对骨水泥注射剂量及邻椎再骨折的影响[J].江苏医药,2016,42(15):1713-1715.
[13]Staples MP,Howe BM,Ringler MD,et al.New vertebral fractures after vertebroplasty:2-year results from a randomised controlled trial[J].Arch Osteoporos,2015,10:229.
[14]Ota K,Iwasaki S.Vertebral bone drilling(puncture)attenuates the acute pain due to vertebral compression fractures[J].Open J Anesthesiol,2014,4(2):46-49.
[15]梅贤忠,刘修华,甘学文,等.椎体成形术中高粘度骨水泥与普通骨水泥渗漏的比较[J].中国中医骨伤科杂志,2017,25(6):57-60.
[16]郭永贤,宋世江,乔培柳,等.高黏度骨水泥经皮椎体成形术联合仙灵骨葆胶囊治疗骨质疏松性椎体压缩性骨折的临床研究[J].中国医药导报,2016,13(24):93-96.
[17]李建赤,黄必留,谭加群,等.高黏度骨水泥经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床研究[J].中国骨与关节外科,2016,9(4):317-321.
[18]笪晓伟,李启中,区杰雄,等.高黏度与低黏度骨水泥在经皮椎体后凸成形术中的应用比较[J].中国骨科临床与基础研究杂志,2015,7(2):79-83.
[19]杨惠林,王根林,姜为民,等.分次灌注骨水泥技术治疗Kümmell病[J].脊柱外科杂志,2012,10(1):22-24.
[20]曾逸文,许建安.经皮椎体成形中的骨水泥分期注射[J].中国组织工程研究,2013,17(12):2117-2122.
[21]Guo D,Cai J,Zhang S,et al.Treating osteoporotic vertebral compression fractures with intraosseous vacuum phenomena using high-viscosity bone cement via bilat eral percutaneous vertebroplasty[J].Medicine(Baltimore),2017,96(14):e6549.
[22]Stevenson M,Gomersall T,Lloyd JM,et al.Percutaneous vertebroplasty and percutaneous balloon kyphoplasty for the treatment of osteoporotic vertebral fractures:a systematic review and cost-effectiveness analysis[J].Health Technol Assess,2014,18(17):1-290.
[23]Ha KY,Kim YH,Yoo SR,et al.Bone cement dislodgement:one of complications following bone cement augmentation procedures for osteoporotic spinal fracture[J].J Korean Neurosurg Soc,2015,57(5):367-370.
[24]Kwon HM,Lee SP,Baek JW,et al.Appropriate cement volume in vertebroplasty:a multivariate analysis with short-term follow-up[J].Korean J Neurotrauma,2016,12(2):128-134.
[25]江晓兵,黄宏伟,张顺聪,等.经皮椎体强化术中骨水泥渗漏与否对患者凝血功能变化的影响[J].中华临床医师杂志:电子版,2013,7(3):996-999.
[26]刘昊,迮骁,邹俊,等.经皮椎体后凸成形术的骨水泥分布与临床疗效分析[J].中华骨与关节外科杂志,2017,10(1):8-12.
[27]Zhang K,Shen Y,Ren Y,et al.Prevention and treatment of bone cement-related complications in patients receiv ing percutaneous kyphoplasty[J].Int J Clin Exp Med,2015,8(2):2371-2377.
[28]Health Quality Ontario.Vertebral augmentation involving vertebroplasty or kyphoplasty for cancer-related vertebral compression fractures:a systematic review[J].Ont Health Technol Assess Ser,2016,16(11):1-202.