后路减压椎体成形短节段融合治疗骨质疏松椎体骨折合并神经损害Posterior neural decompression and short- segment fusion combined with vertebroplasty for osteoporotic vertebral fractures with neurological deficits
薛有地;王兆红;马超;戴维享;
摘要(Abstract):
[目的]探讨后路减压开放椎体成形结合短节段椎弓根螺钉骨水泥强化治疗骨质疏松椎体压缩骨折(osteoporotic vertebral fractures,OVFs)合并神经损伤的临床疗效。[方法]对2008年8月~2012年3月本科手术治疗的23例OVFs合并神经损伤病例进行回顾性分析。术前,术后3、12个月及末次随访时记录手术并发症、VAS评分、ODI评分、SF-36及ASIA分级;X线片测量后凸Cobb角、椎体前缘压缩率,CT矢状面重建测量椎管侵占率。[结果]患者均获随访,平均随访时间47个月(26~69个月)。手术均顺利完成,无死亡及神经损伤加重等并发症,术中3例出现骨水泥渗漏,术后2例切口延迟愈合、1例切口浅表感染、1例脑脊液漏。术后随访VAS评分、ODI评分及SF-36均比术前改善,差异有统计学意义(P<0.05);9例脊髓损伤者术后ASIA分级均至少改善1级;术后后凸Cobb角、椎体前缘压缩率、椎管侵占率均比术前降低,差异有统计学意义(P<0.05)。[结论]后路减压短节段椎弓根螺钉骨水泥强化固定结合开放椎体成形是治疗骨质疏松性椎体压缩骨折合并神经损害安全有效的手术方法。
关键词(KeyWords): 骨质疏松脊柱骨折;神经损害;椎体成形;后路减压;骨水泥强化
基金项目(Foundation):
作者(Author): 薛有地;王兆红;马超;戴维享;
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参考文献(References):
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