【摘要】 目的 探讨经皮椎体成形术、椎体后凸成形术治疗多节段老年骨质疏松性脊柱压缩骨折的疗效。方法 根据影像学特点，对13例老年骨质疏松性多节段脊柱压缩骨折选择性进行单侧经皮椎体成形术或球囊扩张椎体后凸成形术。年龄54～83岁;其中2个椎体压缩8例，3个椎体压缩4例 ,4个椎体压缩1例。结果 13例在术后腰背部疼痛基本消失,24小时 后均离床活动,患者的视觉模拟评分(VAS)由术前(8.3±1.5)分降至术后(2.5±1.2)分，手术前后差异有统计学意义(P<0.01)，椎体高度恢复明显,Cobb角平均矫正10.17°。术后随访6～12 个月,腰背痛无复发。结论 对多节段老年骨质疏松性脊柱骨折的患者，根据影像学特点选择经皮椎体成形术、球囊扩张椎体后凸成形术治疗能取得满意的疗效。
【关键词】 椎体成形术 脊柱骨折 骨质疏松 老年
Treatment of multivertebral spinal fracture in elderly patients with osteoporosis
by percutaneous vertebroplasty and percutaneous kyphoplasty
TIAN Huake,WANG Jian
Department of Orthopedics,Xinqiao Hospital,Third Military Medical University,Chongqing 400037,China
Abstract： Objective To evaluate the effect of percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of compression fracture of multivertebra in elderly patients with osteoporosis.Methods The clinical history of 13 elderly patients,aged 54 to 83 years,of spine suffering from compression fracture of the vertebrae,were retrospectively reviewed.Among them,8 patients suffered compressed fracture of 2 vertebrae,4 with fracture of 3 vertebrae,1 with fracture of 4 vertebrae.Each patient was treated selectively by percutaneous vertebroplasty or percutaneous kyphoplasty according to the results of their imaginal characters.Results Low back pain disappeared nearly in all 13 cases.Patients can be ambulatory in 24 hours postoperatively.Preoperative and postoperative VAS was significantly different(P<0.01).Vertebral heights and Cobb angle improved significantly(P<0.05) after the surgery.There was no relapse of low back pain or collapse of vertebral body after 1 to 12 months follow up.Conclusion Treatment of multivertebral spinal fracture in elderly patients with osteoporosis by percutaneous vertebroplasty and percutaneous kyphoplasty according to imaginal characters has satisfactory clinical efficacy.
Key words:vertebroplasty;spinal column fra
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