| 樊仕才,金大地,张忠民,王 华,李 涛,卢 魁,赵 畅,曾参军.骨水泥强化椎弓根螺钉固定治疗老年退行性腰椎不稳的临床疗效分析[J].中国脊柱脊髓杂志,2010,20(9):741-744. |
| 骨水泥强化椎弓根螺钉固定治疗老年退行性腰椎不稳的临床疗效分析 |
| 中文关键词: 聚甲基丙烯酸甲酯 椎弓根螺钉 骨质疏松 腰椎不稳 强化 |
| 中文摘要: |
| 【摘要】 目的：探讨用聚甲基丙烯酸甲酯（polymethylmethacrylate，PMMA）骨水泥强化椎弓根螺钉内固定治疗老年退行性腰椎不稳的临床疗效。方法：回顾性分析2002年3月~2009年6月收治的23例老年腰椎退行性不稳患者的临床资料，其中：男6例，女17例；年龄62~77岁，平均71岁；均采用PMMA骨水泥强化椎弓根螺钉内固定、椎体间植骨融合治疗，术前测量待置入螺钉之椎体的骨密度，术中测量螺钉的最大旋入力偶矩；取出螺钉后经钉道注入3ml粘稠的PMMA，再拧入螺钉，10min后拧紧螺钉并测量螺钉的最大旋入力偶矩；减压后行植骨融合内固定。结果：所有患者随访7~24个月，平均17个月，腰腿痛治愈好转率达87%，无手术并发症发生。PMMA强化椎弓根螺钉后，螺钉的最大旋入力偶矩由0.591±0.213N·m增至1.332±0.377N·m，差异有显著性（P<0.01）；影像学表现为骨水泥分布于钉道周围松质骨中，未出现椎体外渗漏。结论：骨水泥强化椎弓根螺钉内固定治疗老年退行性腰椎不稳能明显增强螺钉的稳定性；正确掌握进钉技术及螺钉强化技术是手术成功的关键。 |
Department of Orthopaedic Surgery，The 3rd Affiliated Hospital of Southern Medical University，510063，Guangzhou，China |
| 英文关键词:Polymethylmethacrylate Pedicle screw Osteoporosis Lumbar instability Augmentation |
| 英文摘要: |
| 【Abstract】 Objective：To determine the clinic efficacy of PMMA augmented pedicle screw instrumentation for degenerative lumbar instability.Method：From March 2002 to June 2007，23 cases with degenerative lumbar instability undergoing PMMA augmented pedicle screw instrumentation were included in this study.There were 6 males and 17 females，with the average age of 71 years（range，62-77 years）.Preoperative bone density and maximum screw insertion torque was measured.Pedicle screw were augmented with PMMA and 10 minute later the insertion torque was measured again，which was followed by decompression and bone graft．Result：All patients were followed up for 7-24 months and no peripheral complications were noted．The improving rate of lower back pain and neurological deficits was 87%．The screw insertion torque enhanced from 0.591±0.213N·m to 1.332±0.377N·m after augmentation，which showed significant difference（P<0.01）．PMMA distribution around screw was noted with no leakage．Conclusion：PMMA augmented pedicle screw instrumentation enhance the screw strength significantly，and the appropriate surgical maneuver is critical to ensure a good prognosis. |
| 投稿时间：2010-04-26 修订日期：2010-06-13 |
| DOI：10.3969/j.issn.1004-406X.2010.[issue].741.3 |
| 基金项目: |
|
| 摘要点击次数: 2913 |
| 全文下载次数: 3020 |
| 查看全文 查看/发表评论 下载PDF阅读器 |
| 关闭 |
