CAJ | 학술논문

目的：探讨经皮椎体成形术治疗老年骨质疏松引起的胸腰椎爆裂性骨折的临床效果。方法2010年1月～2012年10月，对25例不伴有明显神经症状的胸腰椎爆裂性骨折的老年患者行经皮椎体成形术。术前结合体位复位，术中根据骨折特点个体化穿刺及注入骨水泥，有效固化椎体、恢复椎体高度、纠正后凸成角。术后1、6、12个月随访疼痛视觉模拟评分（ VAS）、伤椎高度恢复率、伤椎后凸Cobb角。结果所有患者术后即可获得椎体稳定，腰痛VAS评分较术前明显降低（2．5±0．9 vs．9．2±0．8，P＝0．000），椎体高度恢复（85．2％±4．4％ vs．80．3％±4．1％，P＝0．000），后凸Cobb 角减小（8．1°±2．1°vs．11．4°±2．4°，P＝0．000），23例获得随访，术后12个月疼痛VAS评分进一步降低，术后6、12个月椎体高度、后凸Cobb角无明显丢失。结论经皮椎体成形术可用于治疗老年骨质疏松爆裂性骨折，安全有效，但需要谨慎选择适应证及个体化制定手术方案。
목적：탐토경피추체성형술치료노년골질소송인기적흉요추폭렬성골절적림상효과。방법2010년1월～2012년10월，대25례불반유명현신경증상적흉요추폭렬성골절적노년환자행경피추체성형술。술전결합체위복위，술중근거골절특점개체화천자급주입골수니，유효고화추체、회복추체고도、규정후철성각。술후1、6、12개월수방동통시각모의평분（ VAS）、상추고도회복솔、상추후철Cobb각。결과소유환자술후즉가획득추체은정，요통VAS평분교술전명현강저（2．5±0．9 vs．9．2±0．8，P＝0．000），추체고도회복（85．2％±4．4％ vs．80．3％±4．1％，P＝0．000），후철Cobb 각감소（8．1°±2．1°vs．11．4°±2．4°，P＝0．000），23례획득수방，술후12개월동통VAS평분진일보강저，술후6、12개월추체고도、후철Cobb각무명현주실。결론경피추체성형술가용우치료노년골질소송폭렬성골절，안전유효，단수요근신선택괄응증급개체화제정수술방안。
Objective To explore the feasibility and clinical effect of percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar burst fractures . Methods From January 2010 to October 2012, a series of 25 senile patients with osteoporotic thoracolumbar burst fractures without neurological signs were enrolled .Percutaneous vertebroplasty was performed in these patients.After position reduction before operation , individualized puncture and injection of bone cement were carried out based on the characteristics of fractures during the operation .The vertebral body was effectively strengthened , the vertebral body height recovered , and the convex angle corrected.Postoperative visual analog scales (VAS), height of fractured vertebra, and the Cobb’s angle on sagittal plane were measured at 1, 6, and 12 months after surgery, respectively. Results Stable vertebral body was obtained in all the patients.The VAS was significantly decreased after operation (2.5 ±0.9 vs.9.2 ±0.8, P=0.000).The height of the fractured vertebra was restored (85.2%±4.4%vs.80.3%±4.1%, P=0.000) and the Cobb’s angle was significantly improved (8.1°± 2.1°vs.11.4°±2.4°, P=0.000).A total of 23 patients were followed up.At 12 months postoperatively, the VAS was further decreased , and the vertebral height and the Cobb ’ s angle were kept unchanged . Conclusions Percutaneous vertebroplasty is an effective treatment for thoracolumbar burst fractures .However, the surgical indications should be strictly followed and the operation plan should be personalized .