改良二维影像导航引导椎体后凸成形术治疗多发性椎体压缩性骨折临床分析

目的 探讨改良二维影像导航方法引导椎体后凸成形术治疗多发性椎体压缩性骨折的临床疗效.方法 28例(73个椎体)多发性骨质疏松椎体压缩性骨折患者,获取手术椎节的正侧位及斜位X线影像,通过影像导航模拟手术椎体的正侧位及椎弓根轴位虚拟影像,引导经皮椎弓根穿刺行椎体后凸成形术.结果 本组28例患者均为单侧穿刺,通过影像导航引导椎弓根穿刺均获成功.术中进行导航虚拟影像与实际穿刺针影像进行匹配,两者影像基本吻合.聚甲基丙烯酸甲酯骨水泥的注射量为2.5～4.0 ml,术后CT复查显示聚甲基丙烯酸甲酯骨水泥填充良好.术后疗效完全缓解11例,部分缓解17例.结论 改良二维影像导航通过术中获取病椎的正侧位及左右的斜位片,模拟手术椎体的三维影像(正侧位及椎弓根轴位的虚拟影像),更加精确地引导椎体后凸成形术治疗多发性椎体压缩性骨折,减少了手术时间和术中辐射暴露时间,使手术更安全、更准确、更微创.     

踝部骨折60例手术治疗

目的 :总结 6 0例踝部骨折治疗效果。方法 :松质骨加压螺钉 ,配合必要的特型钢板内固定。结果 :41例得到随访 ,时间 6～ 2 8个月 ,优良率 91%。结论 :踝部骨折应尽早手术 ,解剖复位 ,坚强内固定和早期功能锻炼     

2型糖尿病合并股骨骨折老年患者骨代谢指标及凝血指标变化的研究

2型糖尿病(Type 2 diabetes mellitus,T2DM)是机体葡萄糖代谢障碍性疾病,患者血糖的升高以及自身胰岛素分泌障碍很大程度上影响了葡萄糖对机体组织细胞的供能,小肠上皮细胞葡萄糖供能障碍易影响机体对钙磷的吸收,目前有大量研究证实老年糖尿病患者易发生骨折及骨质疏松 [1].同时,有研究证实糖尿病患者机...     

改良二维影像导航引导椎体后凸成形术治疗多发性椎体压缩性骨折临床分析

Objective To explore clinlical outcomes of using improved computer-assisted fluoroscopic navi-gation to guide the percutaneous vertebroplasty to treat multiple osteoporotic spinal compression fractures. Methods Twenty-eight multiple osteoporotic spinal compression fractures patients with 73 painful vertebral body were got an-terio posterior,lateral and oblique radiographic imaging by using computer-assisted fluoroscopic navigation to imitate anterior- posterior. Lateral spinal and axial pedicle virtual image was obtained to guide the percutaneous kyphoplas-ty. Results All painful vertebral body were one-sided punctured,all percutaneous kyphoplasties were succeed by guiding with computer-assisted fluoroscopic navigation. Navigation virtual puncture needle image basically matched with reality view. PMMA dosage was 2.5 ～ 4 ml. Postioporational CT showed that the PMMA filled spinal focus very well. 11 cases completely relieved and 17 cases partially relieved. Conclusion Using improved computer-assisted fluoroscopic navigation to guide the PKP to treatment multiple osteoporotic spinal compression fractures decreases op-erative time and radiation injury. It is a safe,precise,minimally invasive method.     

改良二维影像导航引导椎体后凸成形术治疗多发性椎体压缩性骨折临床分析

Objective To explore clinlical outcomes of using improved computer-assisted fluoroscopic navi-gation to guide the percutaneous vertebroplasty to treat multiple osteoporotic spinal compression fractures. Methods Twenty-eight multiple osteoporotic spinal compression fractures patients with 73 painful vertebral body were got an-terio posterior,lateral and oblique radiographic imaging by using computer-assisted fluoroscopic navigation to imitate anterior- posterior. Lateral spinal and axial pedicle virtual image was obtained to guide the percutaneous kyphoplas-ty. Results All painful vertebral body were one-sided punctured,all percutaneous kyphoplasties were succeed by guiding with computer-assisted fluoroscopic navigation. Navigation virtual puncture needle image basically matched with reality view. PMMA dosage was 2.5 ～ 4 ml. Postioporational CT showed that the PMMA filled spinal focus very well. 11 cases completely relieved and 17 cases partially relieved. Conclusion Using improved computer-assisted fluoroscopic navigation to guide the PKP to treatment multiple osteoporotic spinal compression fractures decreases op-erative time and radiation injury. It is a safe,precise,minimally invasive method.     

空心拉力螺钉治疗股骨颈骨折

对于中、青年的股骨颈骨折 ,过去多采用牵引或 3根骨圆针、单一空心加压螺钉、3枚实心螺丝钉等内固定治疗方法 ,但是疗效都不尽人意 ,这是因为股骨头的血液供应在股骨颈骨折后损伤很大 ,容易造成骨不连及骨头坏死。而采用空心拉力螺钉内固定治疗股骨颈骨折具有切口小、损伤少、内固定可靠、患者可早期进行功能锻炼等优点 ,从而降低股骨头坏死的发生率 ,而得到广泛应用。我院在 1996年 4月至 2 0 0 0年 10月采用空心拉力螺钉内固定治疗股骨颈骨折 2 7例 ,取得满意的疗效。报道如下。1　临床资料1 1　一般资料　本组 2 7例 ,男 2 2例 ,女5例 ;…     

改良二维影像导航引导椎体后凸成形术治疗多发性椎体压缩性骨折临床分析

Objective To explore clinlical outcomes of using improved computer-assisted fluoroscopic navi-gation to guide the percutaneous vertebroplasty to treat multiple osteoporotic spinal compression fractures. Methods Twenty-eight multiple osteoporotic spinal compression fractures patients with 73 painful vertebral body were got an-terio posterior,lateral and oblique radiographic imaging by using computer-assisted fluoroscopic navigation to imitate anterior- posterior. Lateral spinal and axial pedicle virtual image was obtained to guide the percutaneous kyphoplas-ty. Results All painful vertebral body were one-sided punctured,all percutaneous kyphoplasties were succeed by guiding with computer-assisted fluoroscopic navigation. Navigation virtual puncture needle image basically matched with reality view. PMMA dosage was 2.5 ～ 4 ml. Postioporational CT showed that the PMMA filled spinal focus very well. 11 cases completely relieved and 17 cases partially relieved. Conclusion Using improved computer-assisted fluoroscopic navigation to guide the PKP to treatment multiple osteoporotic spinal compression fractures decreases op-erative time and radiation injury. It is a safe,precise,minimally invasive method.     

影像导航引导椎体成形术治疗多发性椎体转移瘤的临床分析

目的探讨影像导航引导椎体成形术在多发性椎体转移瘤中的临床应用。方法获取23例多发性椎体转移瘤患者，手术椎节的正侧位及斜位片，采用影像导航的方法虚拟成椎体的正侧位及椎弓根轴位片，引导经皮椎弓根穿刺行椎体成形术。结果本组23例患者均为单侧穿刺，导航引导椎体成形术均获成功，术中进行导航虚拟影像与实际穿刺针影像进行匹配，两者影像基本吻合。PMMA的注射量为2～5ml，术后CT复查显示PMMA填充病灶良好。术后完全缓解8例，部分缓解15例。结论影像导航通过术中获取病椎的正侧位及左右的斜位片，模拟手术椎体的正侧位及椎弓根轴位的虚拟影像，可以更加精确地引导椎体成形术治疗多发性椎体转移瘤，减少了手术时间和术中放射线的照射，使手术更安全、更准确、更微创。     

可扩张型腰椎椎间融合器在退行性腰椎疾病中的应用评价

目的:评价运用可扩张型cage椎体间融合术治疗退行性腰椎疾病的价值。方法:对74例下腰痛患者,采用可扩张型腰椎椎间融合器共融合77个椎间隙,其中L3～43例;L4～543例;L5～S131例。3例需行2个椎节融合。结果:术后随访时间平均11.5个月,根据JOA评分:患者疗效优59.5%,良35.1%,中5.4%。影像随访结果显示,椎间高度术前(7.8±1.5)mm,术后椎间高度(12.0±0.8)mm;未发现融合器移位。结论:可扩张型cage是治疗退行性腰椎疾病的有效方法,良好的手术技巧和选择合适的cage是手术成功的必要条件。     

单侧椎体后凸成形术治疗骨质疏松压缩骨折临床研究

目的 探讨单侧经皮球囊后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的临床疗效.方法 在X线监测下对31例患者(58个椎体)行单侧经皮球囊后凸成形术.采用VAS评分、Oswestry功能障碍评价指数及测量椎体高度丢失率及恢复率对患者手术效果进行比较.结果 患者术后疼痛均缓解,患者随访6～18个月,术后VAS评分与Oswestry功能障碍指数较术前比较差异有统计学意义.结论 单侧经皮椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折疗效显著,能提高手术安全、缩短手术时间、降低射线暴露量和手术费用.