体位复位结合椎体后凸成形术在治疗老年骨质疏松性胸腰段椎体压缩性骨折中的应用

目的:探讨体位复位结合椎体后凸成形术治疗老年骨质疏松性胸腰段椎体压缩性骨折的疗效及可行性。方法:共19例患者26个病椎,均为椎体后壁完整的疼痛性骨质疏松椎体压缩骨折。手术过程包括体位复位,经双侧椎弓根置入2枚可扩张球囊使骨折塌陷椎体复位,用骨水泥充填由球囊扩张所形成的椎体内空腔。观察术后症状改善、骨折复位及并发症情况。结果:19例患者术后疼痛均明显缓解,术后次日即可下床活动。疼痛视觉模拟评分(visual analog scale,VAS)由术前的8.4±1.2分降至术后的2.2±0.8分(P<0.05)。经X线检查确认压缩骨折的椎体高度由术前的16.96mm恢复到术后的20.64mm,后凸畸形平均矫正13.3°。术后平均随访8个月,患者均恢复伤前生活方式,无疼痛,伤椎高度无丢失,无并发症发生。结论:体位复位结合椎体后凸成形术是治疗老年骨质疏松性胸腰段椎体压缩性骨折的安全有效的方法,能迅速缓解疼痛、改善功能并恢复脊柱序列。

Postural Reduction with Kyphoplasty for Aged Osteoporotic Thoracolumbar Compression Fracture

Objective:To evaluate the effect and possibility of postural reduction associated with kyphoplasty for aged osteoporotic thoracolumbar compression fractures.Methods:26 Consecutive procedures were performed in 19 aged patients of painful osteoporotic vertebral compressive fractures with intact posterior vertebral body wall.Under anesthesia postural reduction in stretching prone position was performed at first.Then bilateral insertion of inflatable balloon,fracture reduction and fulfilled with bone cement wer...