中国伤残医学
中國傷殘醫學
중국상잔의학
CHINESE JOURNAL OF TRAUMA AND DISABILITY MEDICINE
2014年
4期
4-6
,共3页
经皮椎体后凸成形术%椎体压缩骨折%骨质疏松性%单侧椎弓根
經皮椎體後凸成形術%椎體壓縮骨摺%骨質疏鬆性%單側椎弓根
경피추체후철성형술%추체압축골절%골질소송성%단측추궁근
Percutaneous kyphoplasty ( PKP)%Osteoporotic vertebral compression fracture%Unipediclular passage
目的：探讨单侧椎弓根入路经皮椎体后凸成形术（ PKP）治疗骨质疏松性胸腰椎体压缩骨折的临床疗效。方法：2009年12月～2012年12月，应用单侧PKP对42例（45个椎体）骨质疏松性胸、腰椎体压缩骨折的患者进行治疗，术前、术后及随访期间进行模拟视觉评分（ VAS）及日本矫形外科协会（ JOA）评分，对其疗效和脊柱后凸角度的改善进行评估。结果：与术前比较，患者术后腰背部疼痛明显缓解，术后VAS评分较术前明显降低（7．62±0．8vs 2．04±1．34，P＜0．01）；手术24小时后可离床活动，功能改善明显，JOA评分较术前明显增高（15．21±3．49 vs 21．86±3．66，P＜0．01）；X光片确认术后脊柱后凸成角显著减小（20．24°±7．6°5vs 9．22°±3．32°，P ＜0．01），显示后凸畸形得到有效纠正。术后有2例出现骨水泥渗漏，在随访期内，除1例患者病变椎体在塌陷，其余患者无其他并发症发生。结论：单侧PKP治疗老年骨质疏松性椎体压缩骨折，症状缓解明显，脊柱后凸成角改善理想，具有良好的治疗效果，但应注意并发症的发生。
目的：探討單側椎弓根入路經皮椎體後凸成形術（ PKP）治療骨質疏鬆性胸腰椎體壓縮骨摺的臨床療效。方法：2009年12月～2012年12月，應用單側PKP對42例（45箇椎體）骨質疏鬆性胸、腰椎體壓縮骨摺的患者進行治療，術前、術後及隨訪期間進行模擬視覺評分（ VAS）及日本矯形外科協會（ JOA）評分，對其療效和脊柱後凸角度的改善進行評估。結果：與術前比較，患者術後腰揹部疼痛明顯緩解，術後VAS評分較術前明顯降低（7．62±0．8vs 2．04±1．34，P＜0．01）；手術24小時後可離床活動，功能改善明顯，JOA評分較術前明顯增高（15．21±3．49 vs 21．86±3．66，P＜0．01）；X光片確認術後脊柱後凸成角顯著減小（20．24°±7．6°5vs 9．22°±3．32°，P ＜0．01），顯示後凸畸形得到有效糾正。術後有2例齣現骨水泥滲漏，在隨訪期內，除1例患者病變椎體在塌陷，其餘患者無其他併髮癥髮生。結論：單側PKP治療老年骨質疏鬆性椎體壓縮骨摺，癥狀緩解明顯，脊柱後凸成角改善理想，具有良好的治療效果，但應註意併髮癥的髮生。
목적：탐토단측추궁근입로경피추체후철성형술（ PKP）치료골질소송성흉요추체압축골절적림상료효。방법：2009년12월～2012년12월，응용단측PKP대42례（45개추체）골질소송성흉、요추체압축골절적환자진행치료，술전、술후급수방기간진행모의시각평분（ VAS）급일본교형외과협회（ JOA）평분，대기료효화척주후철각도적개선진행평고。결과：여술전비교，환자술후요배부동통명현완해，술후VAS평분교술전명현강저（7．62±0．8vs 2．04±1．34，P＜0．01）；수술24소시후가리상활동，공능개선명현，JOA평분교술전명현증고（15．21±3．49 vs 21．86±3．66，P＜0．01）；X광편학인술후척주후철성각현저감소（20．24°±7．6°5vs 9．22°±3．32°，P ＜0．01），현시후철기형득도유효규정。술후유2례출현골수니삼루，재수방기내，제1례환자병변추체재탑함，기여환자무기타병발증발생。결론：단측PKP치료노년골질소송성추체압축골절，증상완해명현，척주후철성각개선이상，구유량호적치료효과，단응주의병발증적발생。
Objective:To evaluate the clinical outcomes and efficiency of unipedicular percutaneous kyphoplasty ( PKP) for senile os-teoporotic vertebral compression fracture .Methods:A total of 42 patients ( 45 vertebrae ) with osteoporotic thoracic vertebra and thoracic vertebra compression fracture underwent unipedicular PKP from December 2009 to December 2012 were reviewed retrospectively .The pre-and post-operational visual analogue scales ( VAS) ,The Japanese Orthopaedic Association ( JOA) back pain scores and local verte-bral Cobb's angles of all cases were measured and evaluated .Results:Compared with pre-operation ,the symptom of back pain in all pa-tients was obviously decreased , the VAS score decreased significantly post -operation(7.62 ±0.8vs 2.04 ±1.34,P<0.01) .All patients could stand up and walk 24 hours after the operation ,and the functions of spine and lower limbs were obviously improved ,the JOA score in-creased significantly (15.21 ±3.49 vs 21.86 ±3.66,P<0.01).By X-ray,The vertebral Cobb's angle after operation was significantly decreased (20.24°±7.6°5 vs 9.22°±3.32°,P<0.01),and this indicated that the deformation of spine kyphosis was effectively correc -ted.Bone cement leakage occurred in 2 cases.In the follow up period,postoperative vertebral collapse occurred in 1 case.The rest of the patients with no other complications occurred .Conclusion:Unipedicular PKP for senile osteoporotic vertebral compression fracture should have a better efficacy:ideal remission of symptoms and satisfactory improvement of spine kyphosis ,but should pay attention to the occur-rence of complications .
