摘要
目的 探讨经皮穿刺、球囊扩张椎体成形术治疗老年骨质疏松性脊柱压缩骨折的疗效。方法 随访老年骨质疏松性脊柱压缩骨折患者 13例 ,男 5例 ,女 8例 ,年龄 6 1～ 78岁 ,平均 6 7岁 ,伤椎T112例 ,T12 5例 ,L13例 ,L2 2例 ,1例为T10 ～L14个椎体。在C型臂X线机或导航系统下 ,采用经皮穿刺 ,在椎弓根建立 4 5mm直径的管性通道 ,将耐高压可扩张球囊置入伤椎 ,高压注入造影剂使球囊扩张 ,将松质骨向两侧终板挤压 ,抬高椎体 ,X线确认椎体高度恢复或终板变形 ,记录球囊压力以及容量 ,抽出造影剂 ,并取出球囊 ,将计算好的同体积等温固化骨水泥注入扩张产生的空腔 ,待骨水泥固化后 ,拔除工作套管 ,手术完成。结果 13例患者术后腰背部疼痛基本消失 ,6～ 8h后可以离床活动 ,术后X线确认压缩骨折椎体基本复位 ,后凸畸形平均矫正 14°(10°～ 2 8°) ,术后随诊 1～ 12个月 ,腰背痛无复发 ,伤椎高度无丢失。结论 经皮穿刺、球囊扩张椎体成形术作为治疗老年骨质疏松脊柱压缩骨折的一种新型微创技术 ,操作简便 ,能够迅速缓解疼痛 ,改善功能。
Objective To evaluate discuss the effect of percutaneous vertebraplasty in the treatment of compression fracture of vertebra in elderly patients with osteoporosis. Methods The clinical history of 13 elderly patients (5 male and 8 female), aged 61 to 78 years (nean 67 years), of spinal suffering from compression fracture of the vertebra, were retruspectively reviewed. Among them, 2 patients suffered compressed fracture of T11, 5 with fracture of T12, 3 with fracture of L1, 4 fracture of L2, and one suffered fracture of four vertebral bodies from T10 to L1. Percutaneous puncture were guided by C-arm X-ray or by computer navigation system, and a canal of 4.5 mm in diameter was created in the pedicle. A balloon was then introduced into the canal, and it was expanded. with radioopaque contrast medium under high pressure. The balloon was then removed after the height of the vertebral body was resumed as verified by X-ray. Bone cement in same volume and temperature was injected in the cavity which was newly formed. The treatment was completed with solidification of the bone cement. Results Low back pain disappeared in all 13 cases. Patients can be ambulatory in 6-8 hours postoperatively. The height of the vertebra body was basic recovered on postoperative X-ray, and kyphosis was rectified to a mean of 14 degrees (range10-28 degree). There was no relapse of low back pain or collapse of vertebral body after 1 to 12 months' follow up. Conclusion Percutaneous expansion of compressed vertebral body is a new kind of microsurgical, treatment for spinal compression fracture in elderly patients with osteoporosis, and it is simple and effective in relieving pain and recovering function.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2005年第1期70-71,共2页
Medical Journal of Chinese People's Liberation Army
关键词
经皮椎体成形术
骨质疏松
脊柱骨折
percutaneous vertebraplasty
osteoporosis
spinal fracture
