椎体后凸成形术治疗骨质疏松性脊柱压缩骨折.doc

1 椎体后凸成形术治疗骨质疏松性脊柱压缩骨折作者:海涌陈志明彭军吴继功马华松邹德威【关键词】骨质疏松摘要:[ 目的] 分析椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床和影像学结果, 评价其临床效果。[方法] 本组 43 例骨质疏松性椎体压缩骨折均接受经皮椎体球囊扩张后凸成形术。其中男 19例,女 24例; 年龄 56~ 85岁, 平均 682 岁。本组共 61 个椎体骨折,其中单椎体 26例,两椎体骨折 11 例,三椎体骨折 4 例,四椎体骨折 2 例。椎体骨折部位 T7 ~ L5 。术后对患者的疼痛、日常功能以及影像学结果进行了分析。[ 结果] 所有患者随访 1a 以上, 平均 188 个月(12~36 个月) 。平均 VAS 评分由术前 86 到术后 23 和最终随访 27(P < 0001) , Oswestry 评分由术前 55 到术后 30和最终随访 35(P < 001) 。手术椎体前、中柱平均高度由术前的 1220 mm 到术后的 2538 mm 和最终随访 2636 mm 。脊柱矢状位后凸畸形改善平均 99° (43~22 °) ,随访丢失平均 16° (08~17 °)。4 例发生骨水泥渗漏,但无严重并发症发生。 2 最终随访时有3 例患者发生3 个临近节段椎体压缩骨折。[结论] 球囊扩张椎体后凸成形术可有效恢复骨质疏松性骨折椎体的高度、迅速缓解疼痛、改善病人的功能, 明显减少骨水泥的渗漏率, 是一种安全、有效的治疗方法。关键词:骨质疏松;椎体压缩骨折;微创后凸成形术 Abstract :[ Objective ] To analyze the clinical and radiographic results of kyphoplasty for the treatment of osteoporobe pressive fracture [ Method ] Fortythree patients with osteoporotie pressive fractures were treated with kyphoplasty The re were 19 male and 24 female with an average age of 682 years (ranged,56 ~ 85 years)The fractures included 61 vertebrae totally and there were single vertebra fractures in 26 cases,double in 11 cases,triple in4 cases and quadricfractures in2 cases respectivelyThe levels of fractures ranged from T7 to L5The pain,daily function and radiographic results pared preand postoperatively [ Result ] All patients were followed up for at least one year (12 ~ 36 months,averaged,188 months)VAS pain score improved from 86 preoperatively to 23 postoperatively and was 27 at last follow upOswestry score improved from 55 preoperatively to 30 3 postoperatively and was 35 at last follow upThe hEights of anterior and middle column of the vertebrae increased from 1220 mm to 2538 mm and was 2636 mm at last follow upThe average correction of kyphosis was 99 degree and 16 degree of correction lost at last follow upFour patients had cement leakage without adverse eventThree patients developed three adjacent level fractures at last follow up[ Conclusion ] Kyphoplasty for the treatment of pressive vertebra fracture