经皮椎体成形术治疗不伴神经症状的骨质疏松性椎体爆裂骨折简 |
| |
引用本文: | 沈洪弟,崔烨平,魏志祥,田纪伟. 经皮椎体成形术治疗不伴神经症状的骨质疏松性椎体爆裂骨折简[J]. 实用骨科杂志, 2014, 0(1): 11-13 |
| |
作者姓名: | 沈洪弟 崔烨平 魏志祥 田纪伟 |
| |
作者单位: | [1]昆山市第三人民医院骨科,江苏昆山215300 [2]上海交通大学附属第一人民医院脊柱外科,上海200080 |
| |
摘 要: | 目的探讨经皮椎体成形术(percutaneousvertebroplasty,PVP)治疗不伴神经症状的骨质疏松性椎体爆裂骨折的临床效果。方法回顾性分析2006年9月至2012年6月间我院治疗的25例不伴神经症状的骨质疏松性椎体爆裂骨折患者的临床资料,男9例,女16例;年龄65~82岁,平均73.5岁。损伤节段在T10-L3之间,共36个节段。所有患者均伴有5%~20%的椎管占位。分别于术前和术后1周、1、6、12个月,采用视觉模拟疼痛评分(visualaria—loguescores,VAS)和Oswestq功能障碍指数(oswestrydisabilityindex,ODI)评估患者的临床效果;通过侧位x线片测量患者椎体中线高度和矢状位Cobb角;通过轴位CT测量椎管占位程度,对患者的骨水泥渗漏、感染等并发症情况进行记录。结果9例(25%)椎体发生骨水泥渗漏,但均未出现相关临床症状。无感染、神经损伤、肺栓塞等病例出现。在VAS评分、ODI评分以及椎体中线高度、矢状位Cobb角、椎管占位程度测量评估方面,患者术前与术后各个时间点比较,术后评估结果显著优于术前,差异均有统计学意义(P〈0.05)。结论对于椎管占位5%一20%的无神经功能损害的骨质疏松性椎体爆裂骨折患者而言,PVP技术是一种安全、有效的治疗方法,且不增加病椎椎管占位程度加重的风险。
|
关 键 词: | 椎体成形术 脊髓损伤 骨质疏松性骨折 后凸 椎管占位 |
Percutaneous Vertebroplasty for the Treatment of the Osteoporosis Vertebral Burst Fractures with- out Neurological Impairment |
| |
Affiliation: | SHEN Hong-di, CUI Ye-ping, WEI Zhi-xiang, et al ( Department of Orthopaedics ,3rd People' s Hospital of Kunshan,Jiangsu 215300, China) |
| |
Abstract: | Objective To investigate the clinical efficacy of percutaneous vertebroplasty (PVP) in the treatment of osteo- porosis vertebral burst fractures without neurological impairment. Methods The clinical data of osteoporosis vertebral burst fractures in 25 patients were analyzed retrospectively from September 2006 to June 2012. There were 9 males and 14 females with the mean age of 73.5 range from 65 to 82 years old including 35 level from T10 to L2,with all patients had 5 to 20% ca- nal encroachment. The pain level of each patient was assessed before operation and 1 week, 1,6,12 months after the operation using visual analogue scale (VAS) and Oswestry disability index (ODI). The middle line vertebral body height and local sag- ittal Cobb' s angle were also measured. Degree of canal encroachment was measured in the axial CT scan. Cement leakage,in- fections and other complications were recorded. Results Bone cement leakage took place in 9 eases (25 % ). None of the 9 cases had clinical symptom. There was no infection, nerve injury, pulmonary embolism. Postoperative average VAS, Oswestry disability index (ODI), the local sagittal Cobb' s angle and spinal canal encroachment at each postoperative time point signifi- cantly less than the preoperative (P 〈 0.05 ). The mean midline vertebral height at each postoperative time point significantly greater than the preoperative (P 〈 O. 05). Conclusion We safely performed vertebroplasty in patients with 5 to 20c~ preoper- ative canal encroachment. Therefore, vertebroplasty might be a safe treatment option for osteoporosis vertebral burst fractures with no neurological deficit. There is no the risk of aggravation of spinal canal encroachment. |
| |
Keywords: | vertebroplasty spinal injuries osteoporotic fractures kyphosis spinal canal encroachment |
本文献已被 CNKI 维普 等数据库收录! |
|