CAJ | 학술논문

背景：椎体成形和椎体后凸成形目前已被广泛应用于骨质疏松性胸腰椎压缩性骨折治疗中，但存在骨水泥渗漏问题，尤其是对于椎体后壁破裂患者更易发生骨水泥渗漏。目的：观察采用高黏度骨水泥及其椎体成形修复骨质疏松性胸腰椎压缩性骨折的疗效。方法：回顾分析采用高黏度骨水泥及其椎体成形修复的20例骨质疏松性胸腰椎压缩性骨折患者的临床资料，治疗后采用目测类比评分评估腰背部疼痛，ODI评分评估腰背部功能，SF-36健康调查评分表评估生活质量， Frankel评分评估神经功能，影像学观察骨水泥渗漏、肺栓塞、邻近椎体骨折等并发症发生情况，X射线评估伤椎椎体前缘高度恢复。结果与结论：随访12-18个月，患者伤椎椎体前缘高度、腰背部疼痛及功能、生活质量均较治疗前明显改善(P<0.05)，神经症状与治疗前相同；复查X射线及CT见骨水泥弥散良好，发生2例骨水泥渗漏，但无任何临床症状；无骨水泥毒性或过敏反应、肺栓塞、感染、神经损伤或新发骨折等并发症发生。说明高黏度骨水泥应用于骨质疏松性胸腰椎压缩性骨折可以明显缓胸腰背部疼痛，改善腰背部功能及生活质量，降低骨水泥渗漏风险。
배경：추체성형화추체후철성형목전이피엄범응용우골질소송성흉요추압축성골절치료중，단존재골수니삼루문제，우기시대우추체후벽파렬환자경역발생골수니삼루。목적：관찰채용고점도골수니급기추체성형수복골질소송성흉요추압축성골절적료효。방법：회고분석채용고점도골수니급기추체성형수복적20례골질소송성흉요추압축성골절환자적림상자료，치료후채용목측류비평분평고요배부동통，ODI평분평고요배부공능，SF-36건강조사평분표평고생활질량， Frankel평분평고신경공능，영상학관찰골수니삼루、폐전새、린근추체골절등병발증발생정황，X사선평고상추추체전연고도회복。결과여결론：수방12-18개월，환자상추추체전연고도、요배부동통급공능、생활질량균교치료전명현개선(P<0.05)，신경증상여치료전상동；복사X사선급CT견골수니미산량호，발생2례골수니삼루，단무임하림상증상；무골수니독성혹과민반응、폐전새、감염、신경손상혹신발골절등병발증발생。설명고점도골수니응용우골질소송성흉요추압축성골절가이명현완흉요배부동통，개선요배부공능급생활질량，강저골수니삼루풍험。
BACKGROUND:Vertebroplasty and kyphoplasty have been widely applied in the treatment of osteoporotic thoracolumbar compression fracture. However, cement leakage is a major problem in the application of this technology, especial y for the vertebral posterior wal ruptured patients. OBJECTIVE:To investigate the therapeutic efficacy of high viscosity bone cement and vertebroplasty in the treatment of osteoporotic thoracolumbar compression fracture. METHODS:A retrospective study was conducted in 20 cases receiving high viscosity bone cement and vertebroplasty surgery for osteoporotic thoracolumbar compression fracture. Clinical outcomes were evaluated mainly with use of Visual Analog Scale for lower back pain. Function of lower back pain was assessed using Oswestry Disability Index questionnaire. Quality of life was evaluated using 36-Item Short Form Health Survey and Frankel score was applied to evaluate neurological function. The anterior vertebral height of the fractured vertebrae was assessed with X-ray. The bone cement leakage, pulmonary embolism, incidence of nearby vertebral fractures and other complications were evaluated during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 12-18 months. The anterior vertebral height of the fractured vertebrae, the lower back pain and function, and quality of life were improved significantly after treatment (P<0.05). Al patients got the same neurological symptoms before surgery. The bone cement dispersion was good after treatment, detected by X-ray and CT scan, only two cases appeared with bone cement leakage, but no clinical symptoms were found. There was no cement toxicity or al ergic complications, pulmonary embolism, infection, nerve injury or new fractures. The high viscosity bone cement used in the treatment of osteoporotic thoracolumbar vertebral compression fractures can significantly relieve thoracic back pain, improve lower back function and quality of life, and greatly reduce the risk of bone cement leakage.