椎体成形术的规范治疗英文.pptxVIP

Vertebroplasty Concept of Minimally Invasive Orthopaedic SurgeryIt is a new technology and new science by application of new apparatus such as endoscope , computer , X-ray , special puncture needle , fixati and et al to get a outcome of minimal incision, less tissue damage, more exactitude, more reliable effe and faster recovery. ConnotationApplication of new medical apparatusLess tissue and mental damageFaster recovery , shorter hospitalization and lower costBetter effect than conventional treatment History Vertebroplasty198419951997France C2 vertebral haemangiomaAmerica beginningAmerica first paper (Jensen) osteoporotic compression fractures Excellent and good rate: 90% VertebroplastyOpen operation, inject bone cement to the vertebrae through the pediclePercutaneous puncture by CT guidancePercutaneous vertebropuncture and inject bone cement by common c-arm x-ray (PVP) PVP in ChinaBegin in 2000 (2nd Affiliated Hospital of SYSU)Fast developmentExcellent and good rate70%Not standard PVP in China（2000年） Evaluation of PVPReviewed 400 cases （47 cases in our hospital）70～80% pain releaseLow rate of failureEarly monvement ?Can not move endplate?Bad correction of defomity, remain kyphosis?Can not make space before injection? High pressure injection, leakage of cementDisadvantage of PVP Percutaneous Kyphosis (PKP)1999 BerkeleyMark ReileyBalloon expansion in the compressed verteb make a empty cavity and decrease the pressure injection.Five steps：① Inject guide needle② Establish work canal③ Expand work canal④ Expand baloon⑤ Inject cement KyphoplastySignificantly decrease cement leakage rateOver 50% correction of kyphosisMarthis reported 80% cases were excellent and good Percutaneous kyphoplasty，PKPAdvantage Recover vertebralheight,correct kyphosisLow cement leakage rate?Disadvantage? Directly uncontrolled expander? Over expand in the adjacent part20% baloon rupture? Only used in fresh fracture? Expensive Expander vertebroplastyIn china (2004)CharacteristicsMutiple direc