球囊辅助复位在高能量爆裂骨折中的应用.doc

Balloon-Assisted Fracture Reduction in High-Energy Burst Fractures球囊辅助复位在高能量爆裂骨折中的应用Dalip Pelinkovic, MD,* Ranjith Kamal Udayakumar, MD,? and Frank M. Phillips, MD*The combination of percutaneus vertebral augmentation with posterior instrumentation may be an attractive treatment option for certain high energy burst fractures. Biomaterials such as calcium phosphate cement are biocompatible, share similar biomechanical prop?erties to bone, and are gradually replaced by host bone tissue. Early biomechanical and clinical results indicate that the anterior column may be restored without the need of a traditional anterior surgical approach. Further clinical studies are needed to con?rm that this less invasive approach improves patient outcome. Semin Spine Surg 22:67-72 ? 2010 Elsevier Inc. All rights reserved.对于某些高能量爆裂骨折而言，经皮椎体增强联合后路器械固定是一个很有吸引力选择。有些生物材料，如磷酸钙骨水泥，具有良好的生物相容性，与骨的生物力学特性相似，可以逐渐被宿主骨替代。早期生物力学和临床结果显示，前柱获得了恢复，不需要再进行传统的前路手术。还需要更多的临床研究来证实这种微创方法对患者结果的促进作用。KEYWORDS burst fracture, percutaneus, balloon-assisted, reduction关键词：爆裂骨折，经皮，球囊辅助，复位。high-energy thoracolumbar burst fractures can be treated with decompression and anterior, posterior, or circum?ferential fusion. Traditionally, reconstruction of the posterior tension band with a rod hook or rod screw construct is ap?plied to assist in providing stability and reestablishing the sagittal balance. Ligamentotaxis may also assist in reducing the vertebra. Despite excellent initial fracture reduction, in?adequate anterior column support may lead to loss of reduc?tion, poor long-term ?xation, or even failure of treatment over time.1-3 Insuf?ciency of the anterior column is caused by both the vertebral body fracture and also migration of the disk tissue through the endplate into the fractured vertebral body, which may not be restored with indirect reduction through posterior instrumentation.4 More extensive anterior procedures, such as anterior instrumentation and strut graft?ing, or cage implantation may successfully