浙江临床医学
浙江臨床醫學
절강림상의학
ZHEJIANG CLINICAL MEDICAL JOURNAL
2014年
11期
1711-1713
,共3页
严重椎体压缩骨折%椎体后凸成形术%胸椎%腰椎%疗效
嚴重椎體壓縮骨摺%椎體後凸成形術%胸椎%腰椎%療效
엄중추체압축골절%추체후철성형술%흉추%요추%료효
Severe osteoporotic vertebral compressive fractures%Kyphoplasty%Lumbar vertebrae%Thoracic vertebrae%Outcome
目的：观察体位复位辅助下单球囊双侧交替扩张后凸成形术治疗严重骨质疏松性椎体压缩骨折的临床疗效。方法回顾分析2009年1月至2012年2月，采用单球囊双侧交替扩张后凸成形术结合体位复位治疗骨质疏松性椎体压缩骨折患者32例（36椎），其中男5例，女27例；年龄61~91岁，平均71.2岁。患者椎体压缩程度75.1%~80.2%，平均77%。取俯卧位调节手术床使患者椎体骨折部位过伸，达到一定闭合复位后，在”C”型臂X线机引导下，经皮穿刺进针，经两侧椎弓根建立工作通道后，一侧放入可扩张球囊，行两侧缓慢交替扩张。复位基本满意或球囊到达椎体皮质时停止扩张，取出球囊，在”C”型臂X线机监视下将骨水泥注入椎体。根据术前和术后侧位X线片测量椎体高度、后凸畸形角度。记录分析视觉模拟评分（visual analogue scale，VAS）及伤椎形态变化。结果椎体前壁高度和中间高度明显恢复，后凸畸形得到矫正，术后伤椎处疼痛均显著缓解，VAS评分从术前平均（7.28±1.11）分降至术后平均（1.92±0.73）分。结论单球囊双侧交替扩张后凸成形术结合体位复位是治疗严重骨质疏松性椎体压缩骨折的可行及有效方法。
目的：觀察體位複位輔助下單毬囊雙側交替擴張後凸成形術治療嚴重骨質疏鬆性椎體壓縮骨摺的臨床療效。方法迴顧分析2009年1月至2012年2月，採用單毬囊雙側交替擴張後凸成形術結閤體位複位治療骨質疏鬆性椎體壓縮骨摺患者32例（36椎），其中男5例，女27例；年齡61~91歲，平均71.2歲。患者椎體壓縮程度75.1%~80.2%，平均77%。取俯臥位調節手術床使患者椎體骨摺部位過伸，達到一定閉閤複位後，在”C”型臂X線機引導下，經皮穿刺進針，經兩側椎弓根建立工作通道後，一側放入可擴張毬囊，行兩側緩慢交替擴張。複位基本滿意或毬囊到達椎體皮質時停止擴張，取齣毬囊，在”C”型臂X線機鑑視下將骨水泥註入椎體。根據術前和術後側位X線片測量椎體高度、後凸畸形角度。記錄分析視覺模擬評分（visual analogue scale，VAS）及傷椎形態變化。結果椎體前壁高度和中間高度明顯恢複，後凸畸形得到矯正，術後傷椎處疼痛均顯著緩解，VAS評分從術前平均（7.28±1.11）分降至術後平均（1.92±0.73）分。結論單毬囊雙側交替擴張後凸成形術結閤體位複位是治療嚴重骨質疏鬆性椎體壓縮骨摺的可行及有效方法。
목적：관찰체위복위보조하단구낭쌍측교체확장후철성형술치료엄중골질소송성추체압축골절적림상료효。방법회고분석2009년1월지2012년2월，채용단구낭쌍측교체확장후철성형술결합체위복위치료골질소송성추체압축골절환자32례（36추），기중남5례，녀27례；년령61~91세，평균71.2세。환자추체압축정도75.1%~80.2%，평균77%。취부와위조절수술상사환자추체골절부위과신，체도일정폐합복위후，재”C”형비X선궤인도하，경피천자진침，경량측추궁근건립공작통도후，일측방입가확장구낭，행량측완만교체확장。복위기본만의혹구낭도체추체피질시정지확장，취출구낭，재”C”형비X선궤감시하장골수니주입추체。근거술전화술후측위X선편측량추체고도、후철기형각도。기록분석시각모의평분（visual analogue scale，VAS）급상추형태변화。결과추체전벽고도화중간고도명현회복，후철기형득도교정，술후상추처동통균현저완해，VAS평분종술전평균（7.28±1.11）분강지술후평균（1.92±0.73）분。결론단구낭쌍측교체확장후철성형술결합체위복위시치료엄중골질소송성추체압축골절적가행급유효방법。
Objective To evaluate the feasibility and therapeutic effect of combination of postural reduction and Kyphoplasty with one balloon bilateral dilatation in treating severe osteoporotic compressive fractures. Methods Thiety-two patients(36 vertebral bodies) with very severe osteoporotic compressive fractures were included. There were 27 females and 5 males with the mean age of 71.2 years.Patients were treated with posture reduction by extending the operating table,then the reduction of the vertebral body was performed by one balloon dilatation via bilateral transpedicular approach in rotation.And then the balloon was deflated and withdraw, leaving cavity within the vertebral body,which then fulfilled with bone cement.Preoperative and postoperative radiographic findings and visual analog scale(VAS) were recorded. Results All patients reported significant alleviation of the pain after treatment. VAS score was reduced averagely from (7.28±1.11)to(1.92±0.73),the anterior and middle vertebral height was restored and kyphotic abnormality was corrected. Conclusion Combination of postural reduction and Kyphoplasty with one balloon bilateral dilatation is feasible and effective for severe osteoporotic vertebral compressive fractures.
