| 经皮椎体成形术及后凸成形术治疗老年人胸腰椎骨折 |
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Received:January 18, 2010
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| 作者 | Author | 单位 | Unit | E-Mail |
| 刘立春 |
LIU Li-chun |
奉化新桥骨科医院骨一科,浙江 奉化 315500 |
Department of Orthopaedics and Traumatology,the Orthopaedics Hospital of Xinqiao,Fenghua 315500,Zhejiang,China |
liu.li.chun@163.com |
| 丁文军 |
DING Wen-jun |
奉化新桥骨科医院骨一科,浙江 奉化 315500 |
Department of Orthopaedics and Traumatology,the Orthopaedics Hospital of Xinqiao,Fenghua 315500,Zhejiang,China |
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| 李时军 |
LI Shi-jun |
奉化新桥骨科医院骨一科,浙江 奉化 315500 |
Department of Orthopaedics and Traumatology,the Orthopaedics Hospital of Xinqiao,Fenghua 315500,Zhejiang,China |
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| 李丰绩 |
LI Feng-ji |
奉化新桥骨科医院骨一科,浙江 奉化 315500 |
Department of Orthopaedics and Traumatology,the Orthopaedics Hospital of Xinqiao,Fenghua 315500,Zhejiang,China |
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| 期刊信息：《中国骨伤》2010年23卷，第6期，第448-450页 |
| DOI：10.3969/j.issn.1003-0034.2010.06.017 |
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目的： 探讨经皮椎体成形术及后凸成形术治疗老年人新鲜胸腰椎骨折的方法及临床疗效。
方法：2004年5月至2009年3月治疗胸腰椎骨折29例32椎，对18例21椎行经皮椎体成形术 (percutaneous vertebroplasty，PVP)，11例11椎行经皮椎体后凸成形术(percutaneous kyphoplasty，PKP)。术前及术后3 d进行疼痛视觉模拟评分(visual analogue scale，VAS)和活动能力评分；术后观察患者胸腰背部疼痛及生活能力状况，并分析骨水泥渗漏等并发症。
结果：手术全部成功，PVP术18例21椎，平均单椎体手术时间38.6 min，注入骨水泥3.2 ml(2～5 ml)，PKP术11例11椎，平均手术时间43 min，注入骨水泥3.8 ml(2～6 ml)。患者的VAS评分由术前的平均(7.5±0.7)分降至术后3 d的平均(2.2±0.5)分；活动能力评分术后3 d平均 (1.2±0.3)分，较术前的平均(2.4±0.6)分明显改善；椎体高度由术前平均(52.4±9.7)％升至术后的(85.2±10.6)％；后凸畸形Cobb角平均矫正11.2°。本组平均随访时间12.6个月，患者骨折椎体无疼痛，复查X线片显示椎体高度无明显丢失。1例出院后5个月、1例6个月因并发心脏病死亡。本组发生骨水泥椎间盘渗漏2例，椎旁渗漏2例，无严重并发症发生，患者对治疗效果满意。
结论：PVP、PKP可即刻加固伤椎，缓解疼痛，提高患者的活动能力，效果明显。老年人新鲜胸腰椎骨折如无明显手术禁忌证，即可行PVP、PKP术。 |
| [关键词]:胸椎 腰椎 骨折 外科手术 老年人 |
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| Percutaneous vertebroplasty and kyphoplasty for the treatment of thoracolumbar fractures in the elderly |
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Abstract:
Objective: To study the clinical effects of percutaneous vertebroplasty and kyphoplasty in the treatment of fresh thoracolumbar fractures in the elderly.
Methods: From May 2004 to March 2009,among 29 patients(32 vertebras) with thoracolumbar fractures,18 patients (21 vertebras) were treated with percutaneous vertebroplasty (PVP) and 11 patients (11 vertebras) were treated with percutaneous kyphoplasty (PKP). The visual analogue scale (VAS) and mobility were evaluated 3 days before and after operation. During follow-up period,patients were observed and evaluated in terms of relief of back pain and regaining of living ability. Complications such as bone cement leakage were analyzed.
Results: All the patients got successful operation. The average operation time was 38.6 minutes for the 18 patients (21 vertebras) with PVP performed,and 3.2 ml(2-5 ml) bone cement was injected. For the 11 patients (11 vertebras) with PKP performed,the average operation time was 43 minutes,and an average of 3.8 ml (2-6 ml) bone cement was injected. The VAS decreased from preoperative(7.5±0.7) to (2.2±0.5) at the 3rd day after operation；the mobility scores of the patients decreased from preoperative(2.4±0.6) to(1.2±0.3) at the 3rd day after operation；the vertebral height increased from an average of (52.4±9.7)％ pre-operation to (85.2±10.6)％ after operation； and the average kyphosis correction of Cobb angle was 11.2°. During an average of 12.6 months follow-up,no patients reported vertebral pain. Review of X-ray films showed no significant loss of vertebral height. One patient died from complications of heart disease 5 months being discharged from hospital. Another patient died from the same cause at 6 months after opertaion. Paravertebral leakage of bone cement was also found in 2 patients. No serious complications occurred and patients were satisfied with the treatment.
Conclusion: PVP,PKP can be used to instantly reinforce vertebral injury,relieve pain,and improve the patient's mobility. For elder people with fresh thoracolumbar fractures,when health conditions are allowed,PVP or PKP surgery is the right treatment. |
| KEYWORDS:Thoracic vertebrae Lumbar vertebrae Fractures Surgical procedures,operative Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 刘立春,丁文军,李时军,李丰绩.经皮椎体成形术及后凸成形术治疗老年人胸腰椎骨折[J].中国骨伤,2010,23(6):448~450 |
| 英文格式: | LIU Li-chun,DING Wen-jun,LI Shi-jun,LI Feng-ji.Percutaneous vertebroplasty and kyphoplasty for the treatment of thoracolumbar fractures in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2010,23(6):448~450 |
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