骨质疏松性椎体骨折伴脊柱后凸畸形的手术治疗Treatment of severe osteoporotic vertebtal compression fractures with spinal kyphosis
章文杰;许晓光;叶嘉靖;洪盾;王章富;洪正华;陈海啸;
摘要(Abstract):
[目的]探讨一种治疗重度骨质疏松性椎体骨折伴脊柱后凸畸形简单而有效的方法。[方法]随访12例重度骨质疏松性骨折伴后凸畸形行短节段椎弓根螺钉固定加伤椎椎体成形术的患者,用PACS阅片软件测量伤椎中部高度与正常椎体高度的比值(压缩比)、脊柱后凸Cobb角,VAS评分评价腰痛程度。[结果]压缩比由术前的(40.50±4.20)%增加至术后的(67.70±7.28)%;Cobb角由术前的(23.41±4.85)°减少为术后3个月的(7.39±3.72)°;VAS评分由术前的(8.56±0.73)分减少为术后3个月的(1.33±0.21)分。[结论]后路短节段椎弓根螺钉固定加伤椎椎体成形术是治疗重度骨质疏松性椎体骨折伴后凸畸形简单而有效的方法。
关键词(KeyWords): 骨质疏松;骨折;后凸畸形;椎弓根;椎体成形术
基金项目(Foundation):
作者(Author): 章文杰;许晓光;叶嘉靖;洪盾;王章富;洪正华;陈海啸;
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参考文献(References):
- [1]Anderson PA,Froyshteter AB,Tontz WL Jr,et al.Meta-analysis of vertebral augmentation compared with conservative treatment for osteoporotic spinal fractures[J].J Bone Miner Res,2013,28(2):372-382.
- [2]Wang E,Yi H,Wang M,et al.Treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty:a report of 196cases[J].Eur J Orthop Surg Traumatol,2013,23(1):71-75.
- [3]Kong LD,Wang P,Wang LF,et al.Comparison of vertebroplasty and kyphoplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral clefts[J].Eur J Orthop Surg Traumatol,2014,24(1):201-208.
- [4]Hartmann F,Gercek E,Leiner L,et al.Kyphoplasty as an alternative treatment of traumatic thoracolumbar burst fractures Magerl type A3[J].Injury,2012,43(4):409-415.
- [5]Wu J,Xu YQ,Chen HF,et al.Percutaneous kyphoplasty combined with the posterior screw-rod system in treatment of osteoporotic thoracolumbar fractures[J].Indian J Orthop,2013,47(3):230-233.
- [6]Patil S,Rawall S,Singh D,et al.Surgical patterns in osteoporotic vertebral compression fractures[J].Eur Spine J,2013,22(4):883-891.
- [7]Kado DM,Huang MH,Nguyen CB,et al.Hyperkyphotic posture and risk of injurious falls in older persons:the Rancho Bernardo Study[J].J Gerontol A Biol Sci Med Sci,2007,62(6):652-657.
- [8]Lee SW,Hong JT,Son BC,et al.Analysis of accuracy of kyphotic angle measurement for vertebral osteoporotic compression fractures[J].J Clin Neurosci,2007,14(10):961-965.
- [9]Huskisson EC.Measurement of pain[J].Lancet,1974,2(7889):1127-1131.
- [10]Burge R,Dawson-Hughes B,Solomon DH,et al.Incidence and economic burden of osteoporosis-related fractures in the United States,2005-2025[J].J Bone Miner Res,2007,22(3):465-475.
- [11]Klazen CA,Lohle PN,de Vries J,et al.Vertebroplasty versus conservative treatment in acute osteoporotic vertebral compression fractures(Vertos II):an open-label randomised trial[J].Lancet,2010,376(9746):1086-1092.
- [12]Mc Call T,Cole C,Dailey A.Vertebroplasty and kyphoplasty:a comparative review of efficacy and adverse events[J].Curr Rew Musuculoskelet Med,2008,1(1):17-23.
- [13]Pradhan BB,Bae HW,Kropf MA,et al.Kyphoplasty reduction of osteoporotic vertebral compression fractures:correction of local kyphosis versus overall sagittal alignment[J].Spine,2006,31(4):435-441.
- [14]Lamartina C,Berjano P,Petruzzi M,et al.Criteria to restore the sagittal balance in deformity and degenerative spondylolisthesis[J].Eur Spine J,2012,21(1):27-31.
- [15]Mac-Thiong JM,Transfeldt EE,Mehbod AA,et al.Can c7 plumbline and gravity line predict health related puality of life in adult scoliosis[J].Spine,2009,34(15):519-527.
- [16]Imagama S,Hasegawa Y,Matsuyama Y,et al.Influence of sagittal balance and physical ability associated with exercise on quality of life in middle-aged and elderly people[J].Arch Osteoporos,2011,6(1-2):13-20.
- [17]Smith JS,Shaffrey CI,Glassman SD,et al.Risk-benefit assessment of surgery for adult scoliosis:an anlysis based on patient age[J].Spine,2011,36(10):817-824.
- [18]Kado DM,Lui LY,Ensrud KE,et al.Hyperkyphosis predicts mortality independent of vertebral osteoporosis in older women[J].Ann Intern Med,2009,150(10):681-687.
- [19]Huang MH,Barrett-Connor E,Greendale GA,et al.Hyperkyphotic posture and risk of future osteoporotic fractures:the rancho Bernardo study[J].J Bone Miner Res,2006,21(3):419-423.
- [20]叶启彬,匡正达,杜明奎,等.脊柱后凸畸形外科治疗的进展与问题[J].中国矫形外科杂志,2011,19(1):7-10.
- [21]Lee SH,Kim ES,Eoh W.Cement augmented anterior reconstruction with short posterior instrumentation:a less invasive surgical option for Kummell's disease with cord compression[J].J Clin Neurosci,2011,18(4):509-514.
- [22]Blondel B,Fuentes S,Metellu SP,et al.Severe thoracolumbar osteoporotic burst fractures:treatment combining open kyphoplasty and short-segment fixation[J].Orthop Traumatol Surg Res,2009,95(5):359-364.
- [23]陈飞,陈宣维,林建华,等.短节段内固定并椎体成形术治疗重度椎体骨质疏松性骨折伴脊柱后凸畸形[J].脊柱外科杂志,2013,11(5):283-287.
- [24]张亮,王静成,冯新民,等.椎弓根螺钉内固定联合椎体成形修复单节段胸椎椎骨质疏松性爆裂型骨折[J].中国组织工程研究,2014,18(17):2722-2727.