椎体后凸成形术治疗重度骨质疏松性椎体压缩骨折

被引：61

作者：

唐海

陈浩

王炳强

李锦军

贾璞

机构：

[1] 首都医科大学附属北京友谊医院骨科

来源：

中华骨科杂志 | 2010年 / 10期

关键词：

骨质疏松; 脊柱骨折; 外科手术;

D O I：

暂无

中图分类号：

R686 [筋腱、韧带、滑囊疾病及损伤];

学科分类号：

100220 [骨科学];

摘要：

目的探讨应用椎体后凸成形术治疗重度骨质疏松性椎体压缩骨折的可行性和疗效。方法 2003年8月至2008年6月,治疗椎体后壁完整的重度骨质疏松性椎体压缩骨折35例(48椎),男2例,女33例;年龄64～86岁,平均74.2岁。患椎压缩程度为75.8%～80.1%,平均77.0%。在"C"型臂X线机引导下经皮穿刺进针,建立工作通道后放入可扩张球囊,行"扩张-放松-再扩张"渐进式复位,扩张压力不超过150 psi(1 psi=6.89 kPa)。复位基本满意或球囊达椎体皮质时停止扩张,取出球囊,在"C"型臂X线机监视下将可显影骨水泥低压注入椎体。结果 35例患者均顺利完成手术。椎体前缘、中部及后缘平均高度分别由术前(0.8±0.1)cm、(0.8±0.2)cm和(2.1±0.8)cm增至术后第3天(1.2±0.3)cm、(1.3±0.2)cm和(2.3±1.0)cm,手术前后椎体前缘、中部高度差异有统计学意义。矢状面Cobb角由术前28.2°±5.2°矫正至术后19.1°±4.9°。疼痛视觉模拟评分(visual analogue scale,VAS)由术前(7.4±1.7)分(5.5～9.4分)降至术后第3天(1.8±1.1)分(0～3.0分)。SF-36健康调查评分由术前(33.2±7.1)分提高至术后第3天(42.7±7.9)分。结论通过改进穿刺复位方法及控制球囊扩张压力,椎体后凸成形术对重度骨质疏松性椎体压缩骨折患者可行且有效。

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