干旻峰;杨惠林;邹俊;王根林;梅昕;周峰;钱忠来;

• 1:苏州大学附属第一医院骨科

摘要(Abstract)：

[目的]探讨椎体后凸成形术治疗无神经症状的骨质疏松性胸腰段爆裂性骨折的可行性及其疗效。[方法]椎体后凸成形术试行治疗25例无神经症状的骨质疏松性胸腰段爆裂性骨折(Margel分型属A3型)。术中采用骨水泥分次灌注及C型臂X线机动态观察技术。术前、术后及术后12个月时采用疼痛视觉模拟评分(visual analogscore,VAS)评估疼痛程度、Oswsetry功能障碍指数(oswsetry disability index,ODI)评估患者日常生活功能。并测量术前、术后及12个月时骨折椎体前缘高度、中部高度、Cobb角及椎管内骨块占位比例。[结果]术后患者症状迅速缓解,无神经损伤的并发症发生。4例患者少量骨水泥渗漏且无症状性并发症。患者VAS评分由术前8.2分降为术后2.8分(P<0.05),术后12个月随访时维持在3.0分。ODI评分由术前的68.2%±6.6%改善为术后的35.3%±2.8%,术后12个月随访时仍能维持。椎体前缘高度从61.5%±13.9%纠正为术后的85.3%±10.6%(P<0.05),中部高度由73.0%±19.3%纠正为83.3%±7.4%。Cobb角由术前的21.7°±7.8°改善为8.6°±6.6°。随访时椎体高度及Cobb角未见明显丢失。椎管内骨块占位率术前为20.1%±4.1%,而术后为17.8%±1.3%(P>0.05)。[结论]椎体后凸成形术治疗无神经症状的骨质疏松性胸腰段爆裂性骨折是可行的,其疗效是满意的。骨水泥分次灌注及C型臂X线机动态观察技术可能有助于避免或减少骨水泥渗漏。

关键词(KeyWords)： 骨质疏松症;椎体后凸成形术;爆裂性骨折

Abstract:

Keywords:

基金项目(Foundation): 卫生部公益性行业专项基金(编号:200802152、201002018);; 江苏省临床医学中心(编号:LG200601)

作者(Author): 干旻峰;杨惠林;邹俊;王根林;梅昕;周峰;钱忠来;

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