摘要
目的探讨胸腰椎骨折卧床保守治疗继发截瘫的安全隐患,以及在此类患者中应用可灌注骨水泥锚固螺钉的前景分析。方法回顾性分析2014年1月至2016年1月在我院诊断的胸腰椎压缩骨折伴有严重骨质疏松症,骨密度T值平均-3.2,适用于椎体成形术,但患者及家属拒绝手术,而采用卧床保守治疗者5例。结果 5例患者在伤后1～3个月内分别出现压缩骨折程度加重,甚至爆裂骨折,继而导致脊髓神经损害。本组采用后路椎管减压＋骨水泥钉复位内固定术,术后X线提示各钉道与椎体紧密结合,螺钉固定稳定,近期疗效满意。结论伴有严重骨质疏松症的压缩骨折,在全身状况良好的情况下,不建议采用卧床等保守治疗,适合早期手术治疗。如选择切开复位椎弓根螺钉复位内固定术,建议采用骨水泥钉道强化技术,可得到良好的稳定,近期疗效满意。
Objective To explore and analyze conservative treatment in paraplegia secondary to vertebral fracture and the application of cement-augmented pedicle screws. Methods A retrospective analysis was conducted for the clinical data of 5 cases of vertebral Compression fracture from January 2014 to January 2016.All the cases complicated with severe osteoporosis, and the average BMD T-score in femoral neck site of all patients was-3.2, suitable for percutaneous vertebroplasty. But patients and their family members refused the operation, received conservative treatment. Results All the cases suffered aggravated compression fracture, turned into vertebral burst fracture, which could result in spinal cord and neurological dysfunction. All the cases underwent posterior spinal decomperssion and PMMA cement-augmented pedicle screws instrumentation, which can get satisfied fixed effects. Conclusion 1Surgical treatment should be adopted in vertebral compression fracture complicated with severe osteoporosis; 2When posterior spinal decompression was adopted, we recommend PMMA cement- augmented pedicle screws instrumentation, which can get satisfied fixed effects with good safety.
出处
《北京医学》
CAS
2016年第7期666-669,共4页
Beijing Medical Journal
