经皮椎体成形术及后凸成形术在胸腰椎骨质疏松性爆裂骨折中的应用现状

Application of percutaneous vertebroplasty and kyphoplasty in thoracic and lumbar osteoporotic burst fractures

摘要:

经皮椎体成形术（percutaneous vertebroplasty，PVP）及后凸成形术（percutaneous kyphoplasty，PKP）目前广泛地应用于骨质疏松压缩性脊柱骨折中，但对于骨折累及椎管、椎体后壁有破裂甚至占位的爆裂性骨折，该技术曾一度被视为绝对手术禁忌。而中老年患者常发生骨质疏松性椎体爆裂骨折（osteoporotic vertebral burst fractures，OVBF）。他们是否如同骨质疏松性压缩性骨折（osteoporotic vertebral compression fractures，OVCF）患者那样从PVP和PKP手术中获益这个问题，促使越来越多的国内外学者开始研究、探讨，希望评价该技术在OVBF患者中的风险与受益。本文主要综述近十多年来该技术在OVBF中应用的疗效和安全性。

Abstract:

Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are currently widely used in osteoporosis com-pression spinal fractures. However, the techniques were once regarded as absolute surgical contraindications for burst fractures involv-ing the posterior wall of the vertebral body or with canal occupation. Osteoporotic vertebral burst fractures (OVBF) often occur in middle-aged and elderly patients. This question whether the patients with OVBF can benefit from PVP and PKP like patients with osteoporotic compression fractures (OVCF) makes more and more scholars at home and abroad begin to study it, through which, they hope to clarify the risks and benefits of this technique in patients with OVBF. In this paper, we mainly review the efficacy and safety of the technique in OVBF in recent ten years.