（推荐医学）老年骨质疏松性胸腰椎压缩性骨折.ppt

* * * * * * Osteoporosis- serious public health problem 100 million people worldwide at risk 35 million with osteoporosis Another 65 million with low bone mass, placing them at increased risk 28 million in U.S. at risk 10 million with osteoporosis Another 18 million with low bone mass With baby boomers now in their 50’s, problem will continue to increase 1.5 million fractures in U.S. 700,000 spine fractures, more than hip and wrist combined Osteoporosis is traditionally thought of as a disease of women, but one-third of all VCFs occur in men VCF diagnosis difficult Acute -Sudden onset of back pain little or no trauma, -Acute pain may subside but FX heals in deformed state Chronic Signs -What to look for: back pain patient shorter obvious spinal deformity/”dowager’s hump” protuberant abdomen Photos show a classic progression of VCF deformity in a woman between ages 50 to 75. Normal vertebral body vs. fractured one Spine shorter, forward tilt leads to deformity Fractures that are not treated heal in a deformed state 三、经皮椎体成形术（PVP） 手术步骤： * 传统手术切口12-16cm PVP手术切口1-2cm * 术 前 三、经皮椎体成形术（PVP） 王某，女，61岁 T12椎体压缩性骨折 术 后 * * 向大家介绍 缺点多 优点多 传统手术 椎体成型 三、经皮椎体成形术（PVP） * 术 式 项 目 椎体成型术 传统手术 麻醉方式 局麻（安全） 全麻（风险大） 手术时间 30--45分钟 2—3小时 适 应 症 广泛(压缩性骨折、肿瘤等) 主要适用于骨折 下床时间 24--48h 术后4周 止痛起效时间 术后即起效 术后3天左右 手术切口 1—2cm 12—16cm 住院时间 3—5天 14—18天 出血量 5-10ml 200-300ml 住院费用 0.6万—1.2万 2万—2.5万 传统手术与微创手术比较 三、经皮椎体成形术（PVP） * 椎管减压椎弓根钉棒内固定术 术前 李某，男，42岁 L2椎体压缩性骨折 术后 *