徐治平;郑昌坤;勘武生;李鹏;

• 1:华中科技大学同济医学院附属普爱医院
• 2:武汉骨科医院

摘要(Abstract)：

[目的]回顾性分析经皮椎体后凸成形术治疗新鲜与陈旧性骨质疏松性椎体压缩性骨折的临床疗效。[方法]2007年9月～2011年3月经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折患者121例159个椎体。新鲜组共75例105个椎体,男14例,女61例;年龄56～86岁,平均72.1岁。陈旧组共46例54个椎体,男15例,女31例;年龄54～80岁,平均68.8岁。所有患者均在C型臂X线机引导下,经皮穿刺完成手术。术后定期随访脊柱正侧位X线片,测量骨折椎体前缘、中部、后缘高度和后凸角度变化,采用视觉模拟数字法判断腰背痛的缓解情况,应用Oswestry功能障碍指数评估生活质量。[结果]所有患者手术顺利完成,新鲜组平均每个椎体手术时间(41±23)min,陈旧组平均每个椎体手术时间(53±26)min,两组间差异有统计学意义(P<0.05);新鲜组每个椎体平均骨水泥注入量(5.1±1.9)ml,陈旧组每个椎体平均骨水泥注入量(5.5±2.1)ml,两组间差异无统计学意义(P<0.05)。随访12～30个月,疼痛VAS评分:新鲜组术前平均(7.7±2.0)分,术后(2.3±1.9)分,末次随访(2.6±2.1)分,手术前后差异有统计学意义(P<0.05);陈旧组术前平均(7.8±2.1)分,术后(4.1±1.9)分,末次随访(4.3±2.3)分,手术前后差异有统计学意义(P<0.05);椎体后凸角矫正:新鲜组Cobb角平均矫正(53.1±6.2)°,陈旧组平均矫正(42.1±6.0)°,各组手术前后比较,差异有统计学意义(P<0.05)。两组术后Oswestry功能障碍指数间差异有统计学意义。两组共发生骨水泥渗漏9例,均无神经症状。[结论]经皮椎体后凸成形术对新鲜骨折疗效要明显优于陈旧性骨折,应在发现患者存在压缩骨折后尽早施行手术。

关键词(KeyWords)： 经皮椎体后凸成形术;骨质疏松性椎体压缩骨折;手术疗效

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 徐治平;郑昌坤;勘武生;李鹏;

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参考文献(References)：

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