骨质疏松性脊柱骨折治疗的现状与展望

被引：11

作者：

白成瑞

机构：

[1] 首都医科大学北京友谊医院骨科

来源：

中国骨质疏松杂志 | 2007年 / 10期

关键词：

内固定; 椎体后凸成型术; 前凸成型术; 神经损伤; 骨质疏松; 脊柱; 椎体成型术;

D O I：

暂无

中图分类号：

R580 []; R683.2 [脊椎骨折];

学科分类号：

100220 [骨科学];

摘要：

对于脊柱外科医生来说,骨质疏松的脊柱问题有疼痛性椎体压缩性骨折,骨折后椎体持续不稳,以及由于多发椎体压缩造成的渐进性体态改变和骨质疏松性骨折引起的神经并发症。运用聚甲基丙烯酸甲脂(PMMA)对骨质疏松的椎体进行强化是十分有效的治疗方法之一。虽然在大部分病例中,由于椎体骨折造成的疼痛会在前几周内逐渐缓解,但仍然有相当数量患者持续疼痛并且椎体持续性塌陷。经皮椎体注入骨水泥会使80%～93%的患者产生迅速而持久的疼痛缓解。多个椎体同时注入还能使严重骨质疏松的脊柱成为一个整体,从而更加有效的阻止椎体进一步塌陷和保持体态。在新鲜的骨折中,球囊扩张椎体成型术可以改善脊柱前凸,若实施前凸成型术会更有效。脊椎后凸的矫正范围为8.5°～14°。椎体高度可以恢复90%。当获得稳定性后,为了在严重骨质疏松的骨质上锚住内固定物,将聚甲基丙烯酸甲脂(PMMA)强化和螺钉内固定相结合是目前惟一的方式。

引用

页码：754 / 757

页数：4

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