CAJ | 학술논문

目的探讨采用小剂量骨水泥椎体成形术治疗多节段骨质疏松伴椎体压缩性骨折的临床效果.方法回顾性研究自2006年9月至2011年8月我院采用小剂量骨水泥椎体成形术治疗46例多节段骨质疏松伴椎体压缩性骨折的病例.其中,男11例,女35例,年龄56~83岁,平均67.3岁.所有患者术前均行骨密度测定T值≤-2.5,提示骨质疏松,并行X线片、CT及MRI检查明确责任椎体及后壁完整情况.本组治疗的病例均为多节段椎体压缩性骨折,责任椎体分别分布在:胸6椎(1个)、胸7椎(1个)、胸8椎(2个)、胸9椎(2个)、胸10椎(5个)、胸11椎(11个)、胸12椎(31个)、腰1椎(36个)、腰2椎(8个),腰3椎(9个)、腰4椎(13个)、腰5椎(14个)等,本组治疗的病变椎体最少2个,最多4个,平均2.32个.所有患者均经单侧椎弓根穿刺椎体,1次对2个或2个以上责任椎体行小剂量骨水泥椎体成形术.术前、术后3天、1周、术后6个月随访时进行疼痛视觉类比评分(VAS),评价临床治疗效果.结果46例患者共行108个椎体成形术,平均1次2.32个椎体,单个椎体内骨水泥注射剂量约1.2~2.1 ml,平均(1.8±0.38)ml.所有患者定期随访,随访时间6~18个月(平均12.6个月),术前患者VAS评分为7.95±0.82,术后3天VAS评分为4.48±0.80,随访时VAS评分为2.38±0.55,采用配对 t 检验对术前、术后随访时VAS评分进行统计学分析,差异有统计学意义(P<0.001,α=0.05).结论小剂量骨水泥椎体成形术作为一种微创手术,可有效地缓解多节段骨质疏松伴椎体压缩性骨折引起的疼痛症状,是一种有效的治疗方法.
목적탐토채용소제량골수니추체성형술치료다절단골질소송반추체압축성골절적림상효과.방법회고성연구자2006년9월지2011년8월아원채용소제량골수니추체성형술치료46례다절단골질소송반추체압축성골절적병례.기중,남11례,녀35례,년령56~83세,평균67.3세.소유환자술전균행골밀도측정T치≤-2.5,제시골질소송,병행X선편、CT급MRI검사명학책임추체급후벽완정정황.본조치료적병례균위다절단추체압축성골절,책임추체분별분포재:흉6추(1개)、흉7추(1개)、흉8추(2개)、흉9추(2개)、흉10추(5개)、흉11추(11개)、흉12추(31개)、요1추(36개)、요2추(8개),요3추(9개)、요4추(13개)、요5추(14개)등,본조치료적병변추체최소2개,최다4개,평균2.32개.소유환자균경단측추궁근천자추체,1차대2개혹2개이상책임추체행소제량골수니추체성형술.술전、술후3천、1주、술후6개월수방시진행동통시각류비평분(VAS),평개림상치료효과.결과46례환자공행108개추체성형술,평균1차2.32개추체,단개추체내골수니주사제량약1.2~2.1 ml,평균(1.8±0.38)ml.소유환자정기수방,수방시간6~18개월(평균12.6개월),술전환자VAS평분위7.95±0.82,술후3천VAS평분위4.48±0.80,수방시VAS평분위2.38±0.55,채용배대 t 검험대술전、술후수방시VAS평분진행통계학분석,차이유통계학의의(P<0.001,α=0.05).결론소제량골수니추체성형술작위일충미창수술,가유효지완해다절단골질소송반추체압축성골절인기적동통증상,시일충유효적치료방법.
Objective To investigate the clinical efficiency of minidosal bone cement in percutaneous vertebroplasty (PVP) in the treatment of multi-segmental osteoporosis with vertebral compression fractures. Metheds 46 patients with multi-segmental osteoporosis with vertebral compression fractures were treated by minidosal bone cement in PVP in our hospital from September 2006 to August 2011, whose data were retrospectively analyzed. There were 11 males and 35 females, with an average age of 67.3 years old (range; 56-83 years). All patients displayed osteoporosis by bone density measurement (T≤-2.5) preoperatively. All patients were checked to identify the vertebral body in responsibility and the completeness of the posterior wall by X-ray, CT and MRI. All patients had multi-segmental vertebral compression fractures, among whom 1 vertebral body in responsibility was in T6, 1 in T7, 2 in T8, 2 in T9, 5 in T10, 11 in T11, 31 in T12, 36 in L1, 8 in L2, 9 in L3, 13 in L4, 14 in L5 and so on. There were at least 2 vertebral bodies with lesions and 4 ones at most, with an average of 2.32 ones. All patients underwent unilateral pedicular approach piercing the vertebral body, and were treated by minidosal bone cement in PVP for 2 or more vertebral bodies in responsibility at once. All patients were followed up preoperatively and 3 days, 1 week and 6 months postoperatively. Visual Analogue Scale (VAS) scores were measured to evaluate the clinical efficiency. Results PVP was performed on 46 patients for 108 times, with an average of 2.32 vertebral bodies at once. The injected cement volume into a single vertebral body was about 1.2-2.1 ml, with an average of (1.8±0.38)ml. All patients were followed up regularly, and the mean duration was 12.6 months (range; 6-18 months). Preoperatively the VAS score was 7.95±0.82 points, and was 4.48±0.80 and 2.38±0.55 points respectively 3 days postoperatively and in the follow-up. The paired T-test was used to compare the VAS scores preoperatively and in the follow-up, and the statistical differences were significant (P<0.001, α=0.05). Conclusions PVP with minidosal bone cement as a minimally invasive surgery can effectively relieve the pain caused by multi-segmental osteoporosis with vertebral compression fractures.