胸腰椎骨质疏松骨折处理.pptxVIP

Management of Osteoporotic Fractures of the Thoracolumbar Spine胸腰椎骨质疏松骨折的处理;Approximately 2 million people sustain an osteoporotic fracture in the United States each year; 25% of those are vertebral compression fractures. Most fractures can be treated nonoperatively, using a combination of bracing, physical therapy, and pain medications.Surgical treatment may be considered for patients with severe pain or who have failed nonoperative options. Surgical treatment options include vertebroplasty and kyphoplasty, which involve the injection of bone cement (polymethylmethacrylate) to augment vertebral bone strength; kyphoplasty adds the in?ation of a balloon tamp to help reduce the fracture and create a space for the cement. The risk of cement extravasation is relatively high, especially during vertebroplasty; however, the incidence of symptomatic leaks is relatively low. Overall, both procedures offer low complication rates, excellent pain relief, and improved function after vertebral compression fractures. Semin Spine Surg 22:58-66 ? 2010 Elsevier Inc. All rights reserved. KEYWORDS vertebral compression fracture, osteoporosis, vertebroplasty, kyphoplasty, man- Agement 在美国，每年大约有200万人发生骨质疏松骨折，其中25％是椎体压缩性骨折。大多数骨折可以采用支具、理疗、止痛药等联合的非手术治疗，对于严重疼痛或非手术治疗失败者可以采用手术治疗。手术治疗包括后凸成形和椎体成形术，通过注入骨水泥（聚甲基丙烯酸甲酯）增强椎体。后凸成形通过球囊扩张来复位骨折，并为骨水泥制造一个空间。骨水泥渗漏的机会比较高，特别是椎体成形术。但产生症状者较少。总体而言，两种手术的并发症都很低，都能显著缓解疼痛，提高椎体压缩性骨折的功能。 关键词：椎体压缩性骨折，骨质疏松，椎体成形术，后凸成形术，治疗。;Spectrum of Disease Senile or insuf?ciency fractures are primarily the result of osteopenia and osteoporosis, de?ned by the World Health Organization as a t score less than 1 and less than 2.5, respectively. 1 The t score is the number of standard devia- tions between the patient’s bone mineral density (BMD) and that of the reference value of the BMD of a young adult. It is believed that osteoporosis develops because of the uncou- pling of the normal balance between bone resorption and new bone formation, 2 resulting in a net decrease in bone mass. Os