| 后凸成形术治疗老年多发性骨质疏松性椎体骨折责任椎的选择 |
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投稿时间：2008-11-13
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| 作者 | Author | 单位 | Address | E-Mail |
| 季卫锋 |
JI Wei-feng |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics,the Hospital of TCM of Zhejiang Province,Hangzhou 310006,Zhejiang,China |
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| 华仲森 |
HUA Zhong-sen |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics,the Hospital of TCM of Zhejiang Province,Hangzhou 310006,Zhejiang,China |
huazhongsen@163.com |
| 厉驹 |
LI Ju |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics,the Hospital of TCM of Zhejiang Province,Hangzhou 310006,Zhejiang,China |
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| 马镇川 |
MA Zhen-Chuan |
浙江省中医院骨科,浙江 杭州 310006 |
Department of Orthopaedics,the Hospital of TCM of Zhejiang Province,Hangzhou 310006,Zhejiang,China |
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| 期刊信息：《中国骨伤》2009年，第22卷，第4期，第288-290页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
| 基金项目: |
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中文摘要:
目的：通过后凸成形术治疗老年多发性骨质疏松性椎体骨折疗效分析，阐述“责任椎”选择在老年多发性脊柱压缩性骨折治疗中的重要性。
方法：自2004年5月至2007年10月应用椎体后凸成形术治疗多发性骨质疏松性椎体压缩性骨折19例(38个椎体),通过临床表现、X线、MR确定“责任椎体”24个。手术在C形臂X线透视下进行，经双侧椎弓根穿刺建立工作通道，放入球囊，持续透视监控下注入骨水泥强化椎体。观察术后症状改善、骨折复位及有无并发症发生。
结果：19例患者均顺利完成手术，术后2 d内疼痛均明显缓解，术后次日由卧床转为下地行走，未发现并发症。术前伤椎前缘、中部高度丢失率分别为(34.22±11.51)%、(26.53±11.61)%,术后伤椎前缘、中部高度丢失率分别为(13.21±11.43)%、(15.10±6.50)%;骨折椎体高度基本恢复；后凸畸形Cobb角由术前(24.50±3.10)°矫正至术后的(8.70±4.30)°；手术前患者疼痛视觉模拟数字评分由术前(83.00±6.00)分减少至术后(27.00±5.00)分，手术前后差异均有统计学意义(P<0.01).
结论：后凸成形术治疗老年多发性骨质疏松性骨折在治疗过程中应重视对“责任椎”的选择。“责任椎”的选择需符合：①查体有明显棘突压痛、叩痛的椎体；②X线表现为椎体压缩性改变，MRI表现椎体T1WI低信号T2WI高信号，STIR序列高信号；③影像学表现能够解释临床症状体征。 |
| 【关键词】经皮后凸成形术 骨质疏松 脊柱压缩性骨折 责任椎 |
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| The selection of responsible veterbal body in PKP(percutaneous kyphosis plasty) for aged osteoporotic spinal multiple fracture |
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ABSTRACT
Objective: Through an analysis of the effect of PKP(percutaneous kyphosis plasty) for aged osteoporotic spinal multiple fracture to demonstrate the importance of the selection of responsible veterbal body.
Methods: Twenty-four consecutive procedures were performed in 19 aged patients with osteoporotic spinal compression fractures from May 2004 to October 2007.The 24 responsible veterbal bodies were confirmed by the manifestations of MRI,X-ray,physical examination before the procedures. Established work path through hibateral vertebral arch,put into saccule,poured in bone cement under X-ray perspective. To observe the condition about symptom improving,fractured reduction and complications after operation.
Results: The operations were successfully completed and the pain released obviously at 2 days after operation. The patients can walk next day after operation and no complication found. The mean loss percent of the anterior and middle vertebal heights were respectively(34.22±11.51)% and(26.53±11.61)% before operation,postoperative were respectively(13.21±11.43)% and (15.10±6.50)%. The mean kyphosis corrected from(24.50±3.10)° to(8.70±4.30)°； the VAS scores decreased from 83.00±6.00 to 27.00±5.00. There was significant difference between before and after operation(P<0.01).
Conclusion: :PKP for aged o- steoporotic spinal multiple fractures by selecting true veterbal body has satisfactory clinical efficacy. We should emphasize the importance of the selectivity of responsible veterbal body in the procedures. It needs three essential elements:①Obviously spi- nous process tenderness and rap pain. ② X-rays showed veterbal body compression fracture; MR showed low signal in veterbal body by T1WI, and high signal by T2WI, STIR. ③The manifestation of radiology can be explained clearly by clinical symptomes and signs. |
| KEY WORDS Percutaneous kyphosis plasty(PKP) Osteoporosis Compression fracture of spine Responsibility veterbal body |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 季卫锋,华仲森,厉驹,马镇川.后凸成形术治疗老年多发性骨质疏松性椎体骨折责任椎的选择[J].中国骨伤,2009,22(4):288~290 |
| 英文格式: | JI Wei-feng,HUA Zhong-sen,LI Ju,MA Zhen-Chuan.The selection of responsible veterbal body in PKP(percutaneous kyphosis plasty) for aged osteoporotic spinal multiple fracture[J].zhongguo gu shang / China J Orthop Trauma ,2009,22(4):288~290 |
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