骨质疏松性骨折椎体成形或椎体后凸成形术后再骨折的治疗

目的探讨对椎体成形（VP）或椎体后凸成形（KP）术后再骨折的治疗策略。方法对12例骨质疏松性骨折VP或KP术后再骨折患者,采用VP治疗2例4个椎体,KP治疗5例9个椎体,并结合抗骨质疏松治疗;1例第2次骨折后行KP,第3次骨折后行卧床、抗骨质疏松治疗;其余4例骨折椎体自身再骨折的患者行抗骨质疏松治疗。12例获随访6～12个月。结果经VP或KP治疗的患者术后疼痛缓解显著,经全面抗骨质疏松的患者随访期间未出现再次骨折。结论 VP或KP仍然可以有效缓解骨质疏松性再骨折患者的疼痛,需加强对再骨折患者的抗骨质疏松治疗。

The Treatment of Refractures After Vertebroplasty/kyphoplasty in the Elderly with Osteoporosis

Objective To discuss the treatment of refractures after vertebroplasty（VP）/kyphoplasty（KP） in the elderly with osteoporosis.Methods Twelve patients of refractures after VP/KP in osteoporosis patients were treated,including 2 patients having the treatment at 4 vertebrae using the VP technique and 5 patients at 9 vertebrae using the KP technique.The above seven patients received the treatment of osteoporosis after VP/KP.Another patients underwent KP again after the initial procedure.This patient chose conventional treatment including bed rest and osteoporosis medication when she experienced the third time vertebral fracture.There were still 4 patients experiencing refractures of the same vertebral body after the KP.These 4 patients were treated with osteoporosis medication.The follow-up period was from to 6 to 12 months after the treatment of the lastest refractures.Results The patients treated with VP/KP had marked or complete pain relief.All the patients receiving systematic osteoporosis medication didn＇t undergo refratures over the 6 to 12 months follow-up.Conclusion VP/KP is still a good method for pain relief in the treatment of refractures after initial procedure.It is more important to treat osteoporosis in these elderly adults.