创伤后椎体迟发性骨坏死早期预防及治疗

目的探讨创伤后椎体迟发性骨坏死（Kummell病）的早期预防及治疗。方法将100例有骨质疏松、外伤后表现为腰背痛的患者,按照随机数字表法,随机分为两组,对照组50例：佩带腰围1个月加塞来昔布0.2 g,qd×7 d;实验组50例：绝对卧床1个月加塞来昔布0.2 g,qd×7 d。分别于受伤时,伤后1个月摄腰椎正、侧位X线片和CT,观察椎体内真空现象。对Kummell病患者采用经皮椎体成形术（PKP）进行治疗,术后疗效采用视觉模拟评分系统（VAS）评价。结果对照组有10例伤后1个月时X线片出现椎体压缩骨折伴椎体内真空现象（位于椎体中央上终板部位）,患病率为20%。实验组有2例于伤后1个月时X线片出现椎体压缩骨折及椎体内真空现象,患病率为4%。创伤后Kummell病患病率对照组明显高于实验组（P〈0.01）。12例Kummell病患者,VAS评分术前为4.5~7.0（6.14±0.16）分,术后为6.5~9.1（8.23±0.18）分,差异有统计学意义（P〈0.01）。结论骨质疏松患者外伤后影像学无明显异常者,早期绝对卧床1个月对预防创伤后Kummell病有积极作用。PKP可有效缓解Kummell病疼痛。

Early prevention and treatment for delayed post-traumatic osteonecrosis of the vertebral body

Objective To study early prevention and treatment for delayed post-traumatic osteonecrosis of the vertebral body(Kummell disease).Methods 100 cases of osteoporosis patients who had a slight trauma were divided into two groups:control group,50 cases,were given Celecoxib 0.2 g,once a day,7 days all together and Belt waistline one month;experimental group,50 cases,were given Celecoxib 0.2 g,once a day,7 days all together and strict bed rest one month.All cases were checked by X rays in times of trauma and one ...