侧前路钢板固定结合注射性硫酸钙椎体成形术治疗骨质疏松性胸腰段.docVIP

侧前路钢板固定结合注射性硫酸钙椎体成形术治疗骨质疏松性胸腰段 　 作者：魏劲松，曾荣，林颢，李建宁，胡资兵 【摘要】 [目的]探讨侧前路钢板固定结合椎体成形术治疗骨质疏松性胸腰段多椎体压缩性骨折的效果。[方法]对22例患有骨质疏松性多椎体压缩性骨折的病例，进行侧前路钢板固定结合注射性硫酸钙椎体成形术治疗。本组22例患者均有骨质疏松并胸腰段多椎体不同程度的压缩骨折，脊髓神经功能有不同程度损伤。术前常规行X线片、CT或MRI检查，术后X线片，观察脊柱稳定性、脊髓功能及慢性胸腰背痛恢复情况。[结果]所有患者经术后随访植骨部位均达到骨性愈合，感觉、运动功能均有不同程度改善，胸背部疼痛或不适明显缓解，无复发，行椎体成形术的椎体无一渗漏，近期疗效均较满意。[结论]侧前路钢板固定结合椎体成形术有利于同时解决胸腰椎后凸畸形对神经的压迫、脊柱的不稳定及骨质疏松椎体压缩骨折造成的顽固性胸腰背疼痛等问题。 【关键词】 胸腰段; 侧前路; 骨质疏松; 压缩性骨折; 硫酸钙; 椎体成形术 　　Abstract：[Objective]To evaluate the therapeutic effects of the operation of lateroanterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement for treatment of thoracolumbar more vertebral compression fractures with osteoporosis.[Method]Twentytwo patients with osteoporosis and more vertebal compression fractures received lateroanterior internal fixation by plate screw and vertebroplasty by calcium sulfate cement.Functions of spinal cord nerve were damaged in different degrees.Preoperative auxiliary examination of Xray,CT and MRI was used.The spinal stabilization,spinal cord function and the state of chronic lumbodynia were observed by postoperative photographs.[Result]All the patients were followed up,and the implants showed bone union.Sensation and motor function were improved in various degrees.The pain of chest and back or other complaints were obviously relieved.No recurrence occurred.Vertebral bodies by vertebroplasty had no leakage and the shortterm effects were satisfactory.[Conclusion]The operation of lateroanterior internal fixation by plate screw combining vertebroplasty is profitable to simultaneously improve nerve compression of thoracolumbar kyphosis,spine instability,and other chronic pain caused by osteoporotic vertebral compression fractures. 　　Key words：thoracolumbar; lateroanterior; osteoporosis; compression fracture; calcium sulfate; vertebroplasty 　　作者简介：魏劲松(1973-)，男，主治医师，硕士，研究方向：脊柱外科，(电话)0759-2387291，2369019 骨质疏松症是目前困扰老龄胸腰背痛患者的顽症之一。椎体压缩性骨折是其常见的并发症。既往的卧床、支具、药物治疗疗效欠佳。近年来，随着经皮椎体成形术(P