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中华临床医师杂志(电子版)

中华临床医师杂志(电子版) ›› 2019, Vol. 13 ›› Issue (04) : 294 -299. doi: 10.3877/cma.j.issn.1674-0785.2019.04.011

所属专题： 文献；

综述

骨质疏松性椎体压缩性骨折微创治疗技术的研究进展
陈斌彬1, 毛克亚2,†(), 刘建恒2, 韩振川1, 张雅宾3, 刘庆祖1   
  1. 1. 100853　北京，解放军医学院；100853　北京，解放军总医院第一医学中心骨科
    2. 100853　北京，解放军总医院第一医学中心骨科
    3. 100853　北京，解放军总医院第二医学中心肾内科
  • 收稿日期:2018-10-19 出版日期:2019-02-15
  • 通信作者: 毛克亚
  • 基金资助:
    国家自然科学基金(51772328，81702121); 军队后勤重大项目子课题(AWS17J004); 解放军总医院临床科研扶持基金(2017FC-TSYS-2006); 首都卫生发展科研专项(首发2018-4-5014)

Minimally invasive therapies for osteoporotic vertebral compression fractures

Binbin Chen1, Keya Mao2,†(), Jianheng Liu2, Zhenchuan Han1, Yabin Zhang3, Qingzu Liu1   

  1. 1. Medical School of Chinese PLA, Beijing 100853, China; Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
    2. Department of Orthopedics, the First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
    3. Department of Nephrology, the Second Medical Center of Chinese PLA General Hospital, Beijing 100853, China
  • Received:2018-10-19 Published:2019-02-15
  • Corresponding author: Keya Mao
  • About author:
    Corresponding author: Mao Keya, Email:
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引用本文：

陈斌彬, 毛克亚, 刘建恒, 韩振川, 张雅宾, 刘庆祖. 骨质疏松性椎体压缩性骨折微创治疗技术的研究进展[J]. 中华临床医师杂志(电子版), 2019, 13(04): 294-299.

Binbin Chen, Keya Mao, Jianheng Liu, Zhenchuan Han, Yabin Zhang, Qingzu Liu. Minimally invasive therapies for osteoporotic vertebral compression fractures[J]. Chinese Journal of Clinicians(Electronic Edition), 2019, 13(04): 294-299.

随着社会的发展，骨质疏松性椎体压缩性骨折的发病率逐年上升，该疾病的治疗方法有保守治疗和手术治疗，微创手术以其明确的临床疗效被广大患者和医务工作者所认可，微创手术技术包括经典的经皮椎体成形术、经皮后凸椎体成形术和较新的OptiMesh技术和弯角椎体成形术等，本文综述了椎体成形微创手术技术的研究进展。

关键词: 骨质疏松, 椎体压缩性骨折, 椎体成形术, 后凸椎体成形术, 弯角椎体成形术, OptiMesh

With the development of the society, the incidence of osteoporotic vertebral compression fractures has increased year by year. There are currently two kinds of treatments for this disease: conservative treatment and surgical treatment. Minimally invasive surgery has been advocated by many patients and medical workers for its clinical curative effect, which includes classic percutaneous vertebroplasty and percutaneous kyphoplasty as well as newer OptiMesh and curved vertebroplasty. This paper reviews the progress in minimally invasive vertebroplasty for osteoporotic vertebral compression fractures.

Key words: Osteoporosis, Vertebral compression fracture, Vertebroplasty, Kyphoplasty, Curved vertebroplasty, OptiMesh
1
Johnell O, Kanis JA. An estiMeta of the worldwide prevalence and disability associated with osteoporotic fractures [J]. Osteoporos Int, 2006, 17(12): 1726-1733.
2
Melton LJ 3rd, Kallmes DF. Epidemiology of vertebral fractures: implications for vertebral augmentation [J]. Acad Radiol, 2006, 13(5): 538-545.
3
Zuo XH, Zhu XP, Bao HG, et al. Network meta-analysis of percutaneous vertebroplasty, percutaneous kyphoplasty, nerve block, and conservative treatment for nonsurgery options of acute/subacute and chronic osteoporotic vertebral compression fractures (OVCFs) in short-term and long-term effects [J]. Medicine (Baltimore), 2018, 97(29): e11544.
4
Kado DM, Browner WS, Palermo L, et al. Vertebral fractures and mortality in older women: a prospective study. Study of Osteoporotic Fractures Research Group [J]. Arch Intern Med, 1999, 159(11): 1215-1220.
5
Baerlocher MO, Saad WE, Dariushnia S, et al. Quality improvement guidelines for percutaneous vertebroplasty [J]. J Vasc Interv Radiol, 2014, 25(2): 165-170.
6
印平，马远征，马迅, 等. 骨质疏松性椎体压缩性骨折的治疗指南 [J]. 中国骨质疏松杂志, 2015, 21(6): 643-648.
7
Zhang HT, Sun ZY, Zhu XY, et al. Kyphoplasty for the treatment of very severe osteoporotic vertebral compression fracture [J]. J Int Med Res, 2012, 40(6): 2394-2400.
8
Sigaux J, Guignard S, Tuilier T, et al. Efficacity and feasibility of vertebroplasty for severe vertebral fracture: a retrospective study of 12 vertebroplasties [J]. Joint Bone Spine, 2013, 80(3): 328-331.
9
Galibert P, Deramond H, Rosat P, et al. Preliminary note on the treatment of vertebral angioma by percutaneous acrylic vertebroplasty [J]. Neurochirurgie, 1987, 33(2): 166-168.
10
Jensen ME, Evans AJ, Mathis JM, et al. Percutaneous polymethylmethacrylate vertebroplasty in the treatment of osteoporotic vertebral body compression fractures: technical aspects [J]. AJNR Am J Neuroradiol, 1997, 18(10): 1897-1904.
11
Belkoff SM, Mathis JM, Fenton DC, et al. An ex vivo biomechanical evaluation of an inflatable bone tamp used in the treatment of compression fracture [J]. Spine (Phila Pa 1976), 2001, 26(2): 151-156.
12
Garfin SR, Yuan HA, Reiley MA. New technologies in spine: kyphoplasty and vertebroplasty for the treatment of painful osteoporotic compression fractures [J]. Spine (Phila Pa 1976), 2001, 26(14): 1511-1515.
13
Xing D, Ma JX, Ma XL, et al. A meta-analysis of balloon kyphoplasty compared to percutaneous vertebroplasty for treating osteoporotic vertebral compression fractures [J]. J Clin Neurosci, 2013, 20(6): 795-803.
14
Ma XL, Xing D, Ma JX, et al. Balloon kyphoplasty versus percutaneous vertebroplasty in treating osteoporotic vertebral compression fracture: grading the evidence through a systematic review and meta-analysis [J]. Eur Spine J, 2012, 21(9): 1844-1859.
15
Wang H, Sribastav SS, Ye F, et al. Comparison of Percutaneous Vertebroplasty and Balloon Kyphoplasty for the Treatment of Single Level Vertebral Compression Fractures: A Meta-analysis of the Literature [J]. Pain Physician, 2015, 18(3): 209-222.
16
Buchbinder R, Osborne RH, Ebeling PR, et al. A randomized trial of vertebroplasty for painful osteoporotic vertebral fractures [J]. N Engl J Med, 2009, 361(6): 557-568.
17
Kallmes DF, Comstock BA, Heagerty PJ, et al. A randomized trial of vertebroplasty for osteoporotic spinal fractures [J]. N Engl J Med, 2009, 361(6): 569-579.
18
Kroon F, Staples M, Ebeling PR, et al. Two-year results of a randomized placebo-controlled trial of vertebroplasty for acute osteoporotic vertebral fractures [J]. J Bone Miner Res, 2014, 29(6): 1346-1355.
19
Buchbinder R, Golmohammadi K, Johnston RV, et al. Percutaneous vertebroplasty for osteoporotic vertebral compression fracture [J]. Cochrane Database Syst Rev, 2015(4): Cd006349.
20
Macias-Hernandez SI, Chavez-Arias DD, Miranda-Duarte A, et al. Percutaneous Vertebroplasty Versus Conservative Treatment and Rehabilitation in Women with Vertebral Fractures due to Osteoporosis: A Prospective Comparative Study [J]. Rev Invest Clin, 2015, 67(2): 98-103.
21
Wardlaw D, Cummings SR, Van Meirhaeghe J, et al. Efficacy and safety of balloon kyphoplasty compared with non-surgical care for vertebral compression fracture (FREE): a randomised controlled trial [J]. Lancet, 2009, 373(9668): 1016-1024.
22
Klazen CA, Lohle PN, de Vries J, et al. Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures (Vertos II): an open-label randomised trial [J]. Lancet, 2010, 376(9746): 1085-1092.
23
Shi MM, Cai XZ, Lin T, et al. Is there really no benefit of vertebroplasty for osteoporotic vertebral fractures? A meta-analysis [J]. Clin Orthop Relat Res, 2012, 470(10): 2785-2799.
24
Xie L, Zhao ZG, Zhang SJ, et al. Percutaneous vertebroplasty versus conservative treatment for osteoporotic vertebral compression fractures: An updated meta-analysis of prospective randomized controlled trials [J]. Int J Surg, 2017, 47: 25-32.
25
Xiao H, Yang J, Feng X, et al. Comparing complications of vertebroplasty and kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis of the randomized and non-randomized controlled studies [J]. Eur J Orthop Surg Traumatol, 2015, 25 Suppl 1: S77-85.
26
Hu KZ, Chen SC, Xu L. Comparison of percutaneous balloon dilation kyphoplasty and percutaneous vertebroplasty in treatment for thoracolumbar vertebral compression fractures [J]. Eur Rev Med Pharmacol Sci, 2018, 22(1 Suppl): 96-102.
27
Chitale A, Prasad S. An evidence-based analysis of vertebroplasty and kyphoplasty [J]. J Neurosurg Sci, 2013, 57(2): 129-137.
28
Zhang Y, Shi L, Tang P, et al. Comparison of the Efficacy Between Two Micro-Operative Therapies of Old Patients With Osteoporotic Vertebral Compression Fracture: A Network Meta-Analysis [J]. J Cell Biochem, 2017, 118(10): 3205-3212.
29
Chang W, Zhang X, Jiao N, et al. Unilateral versus bilateral percutaneous kyphoplasty for osteoporotic vertebral compression fractures: A meta-analysis [J]. Medicine (Baltimore), 2017, 96(17): e6738.
30
Tan G, Li F, Zhou D, et al. Unilateral versus bilateral percutaneous balloon kyphoplasty for osteoporotic vertebral compression fractures: A systematic review of overlapping meta-analyses [J]. Medicine (Baltimore), 2018, 97(33): e11968.
31
陈任. PKP后骨水泥分布与手术椎体再骨折的关系研究 [J]. 颈腰痛杂志, 2016, 37(5): 376-379.
32
刘钊勇，陈斌，邓志华. 单侧与双侧穿刺经皮椎体成形术在骨质疏松性椎体压缩性骨折治疗中的比较 [J]. 中国现代药物应用, 2016, 10(14): 65-66.
33
涂洪波，靳宇飞，张良, 等. 不同MRI影像特征的骨质疏松性椎体压缩骨折单侧与双侧穿刺椎体成形术的疗效比较 [J]. 创伤外科杂志, 2018, 20(6): 427-430.
34
Chen X, Ren J, Zhang J, et al. Impact of Cement Placement and Leakage in Osteoporotic Vertebral Compression Fractures Followed by Percutaneous Vertebroplasty [J]. Clin Spine Surg, 2016, 29(7): E365-370.
35
Gao C, Zong M, Wang WT, et al. Analysis of risk factors causing short-term cement leakages and long-term complications after percutaneous kyphoplasty for osteoporotic vertebral compression fractures [J]. Acta Radiol, 2018, 59(5): 577-585.
36
Zhang ZF, Huang H, Chen S, et al. Comparison of high- and low-viscosity cement in the treatment of vertebral compression fractures: A systematic review and meta-analysis [J]. Medicine (Baltimore), 2018, 97(12): e0184.
37
黄习彬. 防腐标本椎体成形术中间歇推注法预防骨水泥渗漏的实验研究 [D]. 河北医科大学, 2016.
38
徐林飞，胡侦明，江维, 等. 明胶海绵预注射在椎体成形术中预防骨水泥渗漏的体外研究[J]. 重庆医科大学学报, 2015, 40(2): 207-211.
39
葛建忠，张慧东，靳文剑, 等. CT引导单侧椎体成形术治疗老年骨质疏松椎体压缩性骨折 [J]. 中国骨伤, 2011, 24(10): 824-827.
40
王耀斌，陈书连，曹臣, 等. 侧卧位经皮椎体成形术治疗高龄骨质疏松性椎体压缩性骨折[J]. 中华实用诊断与治疗杂志, 2018, 32(8): 777-779.
41
孙志刚，易小波，张正廉, 等. 手法复位联合经皮椎体成形术治疗老年骨质疏松性椎体压缩性骨折的临床研究 [J]. 实用中西医结合临床, 2018, 18(6): 128-129.
42
杨凡朋，张贤锋，徐应林, 等. 过伸体位复位经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折 [J]. 临床骨科杂志, 2018, 21(4): 419-421.
43
唐向盛. 3D打印数字技术辅助的改良PVP治疗重度骨质疏松性椎体压缩骨折 [D]. 北京中医药大学, 2018.
44
张在田，张绪华，卫志华, 等. 机器人辅助与徒手单侧穿刺椎体成形术治疗骨质疏松性椎体压缩骨折疗效的比较 [J]. 骨科临床与研究杂志, 2018, 3(4): 205-208.
45
张建党，邹德威，马华松, 等. 应用Fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折 [J]. 中国脊柱脊髓杂志, 2011, 21(3): 193-196.
46
Liu Y, Wang C, Wei G, et al. Effect of remote controlled injection manipulator system assisted percutaneous kyphoplasty for treatment of rupture of posterior vertebral osteoporotic vertebral fracture [J]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, 2017, 31(5): 527-533.
47
王翔宇，谭伦，林旭, 等. 光电导航引导单侧穿刺椎体后凸成形术治疗胸腰椎骨质疏松性椎体压缩骨折 [J]. 中国修复重建外科杂志, 2018, 32(2): 203-209.
48
Liebschner MA, Rosenberg WS, Keaveny TM. Effects of bone cement volume and distribution on vertebral stiffness after vertebroplasty [J]. Spine (Phila Pa 1976), 2001, 26(14): 1547-1554.
49
He X, Li H, Meng Y, et al. Percutaneous Kyphoplasty Evaluated by Cement Volume and Distribution: An Analysis of Clinical Data [J]. Pain Physician, 2016, 19(7): 495-506.
50
Murphy KJ, Lin DD, Khan AA, et al. Multilevel vertebroplasty via a single pedicular approach using a curved 13-gauge needle: technical note [J]. Can Assoc Radiol J, 2002, 53(5): 293-295.
51
Kwon YJ. Modified vertebroplasty using a curved probe: technique and preliminary results [J]. Minim Invasive Neurosurg, 2008, 51(3): 187-191.
52
Brook AL, Miller TS, Fast A, et al. Vertebral augmentation with a flexible curved needle: preliminary results in 17 consecutive patients [J]. J Vasc Interv Radiol, 2008, 19(12): 1785-1789.
53
Saxena A, Hakimelahi R, Jha RM, et al. The safety and effectiveness of a curved needle for vertebral augmentation: comparison with traditional techniques [J]. J Vasc Interv Radiol, 2010, 21(10): 1548-1553.
54
李鹏. 弯角椎体成形穿刺装置的研制及应用研究 [D]. 中国人民解放军医学院, 2012.
55
张权. 弯角植入球囊椎体后凸成形装置的可行性研究[D]. 中国人民解放军医学院, 2015.
56
熊森，毛克亚，韩振川, 等. 弯角输送装置在体外椎体成形实验中的效果观察 [J]. 解放军医学院学报, 2016, 37(7): 769-772, 778.
57
熊森，毛克亚，韩振川, 等. 应用弯角椎体成形装置修复胸腰段骨质疏松性椎体压缩骨折[J]. 中国组织工程研究, 2016, 20(17): 2496-2502.
58
周权发，刘宏建，寇红伟, 等. 弯角椎体成形装置的早期疗效评估及对骨水泥分布的影响[J]. 中国矫形外科杂志, 2017, 25(10): 892-897.
59
寇红伟. 弯角椎体成形装置对单侧椎弓根穿刺角度及骨水泥分布的影响 [J]. 中华实验外科杂志, 2017, 34(2): 338-341.
60
钟睿，姜威，熊森, 等. 单侧弯角与直行入路椎体成形治疗骨质疏松性椎体压缩骨折疗效的对照研究 [J]. 中华创伤杂志, 2018, 2(34): 102-108.
61
张大鹏，毛克亚，强晓军. 弯角装置单侧穿刺经皮椎体成形术治疗Kümmell病的临床疗效 [J]. 脊柱外科杂志, 2017, 15(6): 335-338, 343.
62
陈川，胡侦明. 骨质疏松性椎体压缩骨折的微创治疗进展 [J]. 现代医药卫生, 2017, 33(3): 396-398.
63
Lam S, Khoo LT. A novel percutaneous system for bone graft delivery and containment for elevation and stabilization of vertebral compression fractures. Technical note [J]. Neurosurg Focus, 2005, 18(3): e10.
64
Inamasu J, Guiot BH, Uribe JS. Flexion-distraction injury of the L1 vertebra treated with short-segment posterior fixation and Optimesh [J]. J Clin Neurosci, 2008, 15(2): 214-218.
65
Chen C, Li D, Wang Z, et al. Safety and Efficacy Studies of Vertebroplasty, Kyphoplasty, and Mesh-Container-Plasty for the Treatment of Vertebral Compression Fractures: Preliminary Report [J]. PLoS One, 2016, 11(3): e0151492.
66
李东华，刘训伟，彭湘涛, 等. 骨填充网袋灌注骨水泥修复椎体压缩骨折:可降低骨水泥椎体外渗漏率 [J]. 中国组织工程研究, 2015, 19(3): 358-363.
67
He CJ, Liu GD. Comparison of the Efficacy and Safety of Bone-filling Mesh Container and Simple Percutaneous Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures [J]. Pain Physician, 2018, 21(3): 259-268.
68
李康强. Sky骨扩张器行经皮椎体后凸成形术治疗椎体压缩性骨折的临床研究 [J]. 中国医疗器械信息, 2017, 23(23): 78-79.
69
陈敬忠，张东，肖伟, 等. 经皮椎弓根钉棒置入结合椎体成形治疗胸腰椎压缩性骨折的临床研究 [J]. 河北医药, 2018, 40(15): 2272-2275.
70
Li C, Pan J, Gu Y, et al. Minimally invasive pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracolumbar burst fracture [J]. Int J Surg, 2016, 36(Pt A): 255-260.
71
祝乃强，侯静怡，马桂云, 等. 经皮椎弓根螺钉联合椎间孔镜治疗伴有神经功能损害的腰椎爆裂骨折的疗效观察 [J]. 河北医学, 2018. 24(10): 1736-1739.
72
罗军，孙景福，王虎, 等. 后正中小切口减压联合经皮椎弓根螺钉内固定治疗伴神经功能损害胸腰椎骨折的疗效及安全性分析 [J]. 创伤外科杂志, 2018, 20(6): 435-438.
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