椎体后凸成形术治疗骨质疏松性脊柱压缩骨折.DOCVIP

临床医学论文-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1 a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。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 vertebra compressive fracture［Method］Fortythree patients with osteoporotie vertebral compressive fractures were treated with kyphoplastyThere 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 in 4 cases and quadricfractures in 2 cases respectivelyThe levels of fractures ranged from T7 to L5The pain,daily function and radiographic results were compared 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 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 osteoporotie compressive vertebra fracture can r