Objective To investigate the clinical application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis.Methods From June 2010 to June 2013,13 patients ( 4 males,9 females ) of lumbar spinal canal stenosis with osteoporosis were recruited,with an average age of 68 years old ( range: 61-77 years ).Nine cases were in stage two.Four cases were in stage three.Assessing osteoporosis according to Jikei,there were 4 cases of stage Ⅱ and 9 cases of Ⅲ.Bone cement augmentation of the screw channel was conducted before pedicle screw ifxation.Thirty-six bone cement augmented pedicle screws were implanted.Using X-ray during and after the operation to compare pedicle screw positions and observe the stability.Visual analogue scores ( VAS ) was applied to evaluate low back pain and leg pain 1 day before surgery,7 days and 3 months postoperatively.Results Complications due to the bone cement leakage,heat-induced effects and toxicity in the screw implantation process did not occur.The low back pain and leg pain symptoms were improved signiifcantly 1 week postoperatively.VAS were ( 2.20 ± 1.18 ) points and ( 2.32 ± 0.35 ) points respectively,with statistical signiifcance comparing with preoperative condition (P＜0.05 ).VAS were ( 1.82 ± 0.15 ) points and ( 1.14 ± 0.44 ) points in 3 months postoperatively,with no statistical significance comparing with the condition 1 week postoperatively (P＞0.05 ).Thirteen patients were followed up.The average followed up time was 14 months ( range: 8-16 months ).Thirteen cases obtained bony fusion.X-ray showed no loosening,fracture or falling of the internal fixation.No radiolucent lines appeared around the screws.Conclusions Application of bone cement augmentation of pedicle screws in lumbar spinal canal stenosis with osteoporosis can receive satisfactory short-term clinical outcomes.%目的 探讨骨水泥强化椎弓根螺钉在腰椎管狭窄伴骨质疏松患者的临床疗效.方法 2010年6月至2013年6月,我院收治腰椎管狭窄伴骨质疏松患者13 例,其中男4例,女9例,平均年龄68(61～77)岁;二阶段9例,三阶段4例;骨质疏松按Jikei分级,Ⅱ级4例,Ⅲ级9例.所有患者在行经椎弓根螺钉内固定之前先行钉道骨水泥强化,共植入骨水泥强化椎弓根螺钉共36枚,通过术中、术后复查X线片比较椎弓根螺钉位置有无变化来观察椎弓根螺钉术中及术后的稳定性.分别于术前1天、术后7天、3个月采用视觉模拟评分 (visual analogue scores,VAS) 评价腰痛和下肢痛.结果 置入螺钉过程中未发生因骨水泥渗漏、放热效应及毒性反应引起的并发症;术后1周腰痛和下肢痛症状改善明显,VAS 评分分别为 (2.20±1.18) 分和 (2.32±0.35) 分,与术前比较差异有统计学意义 (P＜0.05 );术后 3 个月VAS评分分别为 (1.82±0.15) 分和 (1.14±0.44) 分,与术后 1 周比较差异无统计学意义 (P＞0.05).13 例均获14(8～16) 个月随访.13 例均获得骨性融合,X线片显示内固定无松动、断裂或脱落,螺钉周围未见透亮线出现.结论 骨水泥强化椎弓根螺钉治疗腰椎管狭窄伴骨质疏松患者可获得满意的近期临床疗效.
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