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椎体成形术治疗椎体骨质疏松性压缩骨折 被引量:2

Treatment of osteoporotic spinal compression fractures by percutaneous vertebroplasty
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摘要 目的 通过X线透视下经皮穿刺椎体成形术治疗椎体骨质疏松性压缩骨折 ,探讨该技术的临床疗效。方法 本组 2 9例 (40个椎体 ) ,男 12例 ,女 17例 ;年龄 4 5~ 84岁 ,平均 6 7岁。骨折部位 :T3~L5 ,其中胸椎 13个 ,腰椎 2 7个。采用C型臂透视下俯卧位进行经皮椎弓根椎体穿刺 ,注射骨水泥。在术前、术后 3d、随访期进行疼痛视觉类比评分 (VAS) ,活动能力评分和止痛药使用评分。结果  2 9例 4 0个椎体均手术成功 ,VAS术前 (7 .8± 1. 4 ) ,术后 3d(2 5± 1 0 )较术前显著下降 (P <0 . 0 0 1) ,随访时为 (2 .1± 0 .0 8) ,比术后 3d又略有下降。活动能力评分 :术后 3d(1 6± 0 3)较术前 (2 5± 0 7)明显改善 (P <0 0 5 ) ,随访时 (1 3± 0 5 ) ,活动能力又有进一步改善。使用止痛药评分 :术后 3d(0. 7± 0 . 6 )较术前 (2 . 3± 0 . 5 )明显改善 (P <0 . 0 1) ,随访时 (0. 6± 0 .6 )与术后比较无显著变化。 Objective To evaluate the tharapeutic effect of percutaneous vertebroplasty (PVP) guided by fluoroscopy in treating osteoporotic spinal compression fractures. Methods Twenty-nine patients (17 females and 12 males) with 40 vertebral compression fractures underwent PVP. They were 67 years of age on an average (45-84 years). The fracture segment was within T_3-L_5 (13 thoracical vertebrae, 27 lumbar vertebrae). Under the guidance of C-arm fluoroscopy, bone marrow biopsy needle was inserted percutaneously viavertebral pedicle into the fractured vertebral body. Polymethylmethacrylate (PMMA) was then injected into the fractured vertebrae. Visual analogue scale (VAS), mobility and analgesic usage were evaluated 3 days before and after PVP and in the follow-up period. Results PVP was successful in 29 cases (40 vertebrae). VAS was sharply decreased from 7.8±1.4 pre-PVP to 2.5±1.0 at day 3 after PVP (P<0.001); it decreased slightly to 2.1±0.8 during the follow-up period. Scale of patient's mobility was increased from 2.5±0.7 pre-PVP to 1.6±0.3 at day 3 after PVP with a significant difference (P<0.05); it was 1.3±0.5 during the follow-up period and improved further. Scale of analgesic usage changed from 2.3±0.6 before PVP to 0.7±0.6 3 days after PVP with a significant difference (P<0.01), and was 0.6±0.6 during the follow-up period without significant difference compared with post PVP. Conclusions PVP is an effective mini-invasive technique for osteoporotic spinal compression fractures and can be accomplished safely wnder C-arm single-plane fluoroscopy in most cases.
出处 《中国骨质疏松杂志》 CAS CSCD 2005年第1期74-76,79,共4页 Chinese Journal of Osteoporosis
关键词 治疗 术后 术前 压缩骨折 骨质疏松 经皮穿刺椎体成形术 评分 随访 活动能力 VAS Osteoporosis Spinal fractures Injections Vertebral Bone cements
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参考文献16

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