| CT引导单侧椎体成形术治疗老年骨质疏松椎体压缩性骨折 |
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Received:March 27, 2011
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| 作者 | Author | 单位 | Unit | E-Mail |
| 葛建忠 |
GE Jian-zhong |
阳泉市第一人民医院,山西 阳泉 045000 |
The First People's Hospital of Yangquan,Yangquan 045000,Shanxi,China |
gejianzhongyq@tom.com |
| 张慧东 |
ZHANG Hui-dong |
阳泉市第一人民医院,山西 阳泉 045000 |
The First People's Hospital of Yangquan,Yangquan 045000,Shanxi,China |
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| 靳文剑 |
JIN Wen-jian |
阳泉市第一人民医院,山西 阳泉 045000 |
The First People's Hospital of Yangquan,Yangquan 045000,Shanxi,China |
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| 皇甫金变 |
HUANGPU Jin-bian |
阳泉市第一人民医院,山西 阳泉 045000 |
The First People's Hospital of Yangquan,Yangquan 045000,Shanxi,China |
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| 汪慕华 |
WANG Mu-hua |
阳泉市第一人民医院,山西 阳泉 045000 |
The First People's Hospital of Yangquan,Yangquan 045000,Shanxi,China |
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| 期刊信息：《中国骨伤》2011年24卷，第10期，第824-827页 |
| DOI：10.3969/j.issn.1003-0034.2011.10.007 |
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目的: 评估CT引导经皮单侧椎弓根穿刺,骨水泥注入椎体成形术(Percutaneous vertebroplasty,PVP)治疗老年骨质疏松椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效和安全性。
方法: 2009年8月至2010年6月,对26例接受CT引导PVP治疗的老年椎体压缩性骨折患者进行回顾性分析,男9例,女17例;年龄60～85岁,平均(67.50±6.76)岁;病程2～30 d,平均(8.92±4.36) d.骨折部位累及35椎。临床主要表现为腰背部疼痛(翻身、弯腰时加重),不能承重等。在CT引导下将穿刺针经皮单侧穿刺到病变椎体后,向椎体内注入骨水泥3～5 ml.术后应用抗生素3 d预防感染,观察骨水泥渗漏情况及脊髓、神经损伤,肺栓塞等并发症发生情况。通过X线片测量治疗前后椎体前缘、中部、后缘高度变化并进行比较;采用视觉模拟疼痛评分 (Visual analogue scale ,VAS)对患者术前、术后48 h及末次随访时的疼痛评分进行比较。
结果: 26例穿刺均成功,有6个椎体发生骨水泥渗漏,未出现临床症状。1例患者出现骨水泥反应,给予5 mg氟美松静滴、吸氧后缓解。26例患者均获随访,时间6～12个月,平均(8.4±1.6)个月。未发生神经损伤或肺栓塞等严重并发症。治疗后(48 h)测定椎体前缘、中部、后壁高度较治疗前略有增加,但差异无统计学意义(P>0.05).VAS评分：治疗前为7.63±0.92,治疗48 h后为3.00±1.09,末次随访时为2.38±1.17.治疗前与治疗后48 h相比,差异有统计学意义(P<0.05);末次随访时与治疗后48 h比较,差异无统计学意义(P>0.05).
结论: CT引导单侧PVP具有增强椎体力度,稳定椎体的作用,是治疗老年骨质疏松椎体压缩性骨折一种安全有效的方法。 |
| [关键词]:骨质疏松 脊柱骨折 椎体成形术 |
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| Clinical analysis of CT guided unilateral PVP for the treatment of osteoporotic vertebral compression fracture in senile patients |
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Abstract:
Objective: To evaluate the therapeutic effect and security of CT guided unilateral percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fracture(OVCF) in senile patients.
Methods: From April 2009 to June 2010,26 patients undergoing CT guided unilateral percutaneous vertebroplasty were analyzed retrospectively.There were 9 males and 17 females,ranging in age from 60 to 85 years with an average of(67.50±6.76)years,ranging in course of disease from 2 to 30 days with an average of(8.92±4.36) d.The affected segments involved 35 vertebras.The major clinical manifestations of OVCF were lumbar-back pain (especially when turning over or stooping down) and unable to bear.The needle was punctured into vertebral of lesions through unilateral puncture under the CT guidance; and then 3-5 ml bone cement was injected into vertebral.Antibiotic was used 3 days to prevent postoperative infections.Postoperative complications were observed after operation,such as local leakage of bone cement,penetrating spinal cord and/or segmental spinal nerve injuries and pulmonary embolism.X-ray was used to measure the height of anterior,middle and exterior of vertebral before and after treatment.A visual analog scale (VAS) scoring was applied to evaluate pain score preoperative,48 hours postoperative and the terminal follow-up.
Results: Twenty-six patients achieved success in punctuation without serious complications.Local leakage of bone cement occurred in 6 cases,but without clinical symptoms or signs.One patient suffered from acute intraoperative reactions to bone cement and relieved by 5 mg dexamethasone and oxygen.All patients were followed up for 6 to 12 months[averaged(8.4±1.6) months].The postoperative vertebrae height was higher than preoperative,but there was no statistical difference between postoperative and preoperative(P>0.05).Preoperative VAS scores was 7.63±0.92,postoperative score was 3.00±1.09,the final follow-up score was 2.38±1.17; there was significant difference between preoperative and postoperative at 48 hours(P<0.05),but there was no statistical difference between final follow-up and postoperative at 48 hours(P>0.05).
Conclusion: Unilateral PVP under CT guided can increase the vertebral strength and stabilize vertebral body,and the procedure is a safe and effective method for OVCF in elderly patients. |
| KEYWORDS:Osteoporosis Spinal fractures Percutaneous vertebroplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 葛建忠,张慧东,靳文剑,皇甫金变,汪慕华.CT引导单侧椎体成形术治疗老年骨质疏松椎体压缩性骨折[J].中国骨伤,2011,24(10):824~827 |
| 英文格式: | GE Jian-zhong,ZHANG Hui-dong,JIN Wen-jian,HUANGPU Jin-bian,WANG Mu-hua.Clinical analysis of CT guided unilateral PVP for the treatment of osteoporotic vertebral compression fracture in senile patients[J].zhongguo gu shang / China J Orthop Trauma ,2011,24(10):824~827 |
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