张帅;王清;杨进;李涛;徐双;王高举;

• 1:西南医科大学附属医院脊柱外科

摘要(Abstract)：

[目的]探讨经皮椎体后凸成形术(PKP)骨水泥椎管内渗漏的发生率并行相关危险因素分析。[方法]回顾性分析2008年1月～2017年6月在本科行PKP手术治疗的474例(714个椎体)患者临床资料。观察术后手术部位X线片及CT影像分辨是否有骨水泥椎管内渗漏,依据渗漏途径和椎管内骨水泥分布情况将骨水泥椎管内渗漏分为B型、C型、P型,并分析骨水泥椎管内渗漏相关危险因素。[结果]术后52个椎体(7.28%)发生骨水泥椎管内渗漏(椎管内渗漏组),其中B型29个(55.77%),C型15个(28.85%),P型8个(15.38%)。发生有症状骨水泥椎管内渗漏7例,其中截瘫1例,AISA分级A级,急诊手术减压后,神经功能无改善;不全瘫1例,AISA分级B级,术后恢复为C级;一过性神经功能损害5例,保守治疗后均恢复正常。余662个椎体为非椎管内渗漏组。单因素分析显示两组患者骨折类型、骨水泥注入量及手术操作部位比较差异有统计学意义(P<0.05)。多因素分析显示骨水泥注入量(OR=3.306,95%CI=1.351～8.091,P<0.05)、骨折类型(OR=4.910,95%CI=1.551～15.544,P<0.05)及手术操作部位(OR=0.453,95%CI=0.219～0.939,P<0.05)是导致PKP术后发生骨水泥椎管内渗漏的主要因素。[结论] PKP术后骨水泥椎管内渗漏率约为7.28%,有症状渗漏率约为0.98%。骨水泥注入量、骨折类型及手术操作部位是导致PKP术后发生骨水泥椎管内渗漏的独立危险因素。

关键词(KeyWords)： 骨质疏松性椎体骨折;经皮椎体后凸成形术;骨水泥椎管内渗漏;危险因素

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 张帅;王清;杨进;李涛;徐双;王高举;

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