摘要
目的探讨老年骨质疏松性脊柱压缩性骨折的外科治疗方法以及疗效。方法对132例老年骨质疏松性脊柱压缩性骨折,男35例,女97例,年龄56～78岁,平均66岁,采用经皮穿刺椎体成形术治疗113例,采用切开复位、膨胀式椎弓根钉系统内固定术治疗19例。结果术后122例腰背部疼痛基本消失,椎体成形组术后6～8h可以离床活动,切开复位内固定组术后2d可以离床活动。术后摄X线确认压缩性骨折椎体基本复位,后凸畸形平均矫正15°(10～30°)。术后随访6～36个月,腰背部疼痛无复发,经皮穿刺椎体成形伤椎高度无丢失。切开复位、膨胀式椎弓根钉系统内固定伤椎高度部分丢失。结论经皮穿刺椎体成形术作为治疗老年骨质疏松性脊柱压缩性骨折有手术微创、操作简便、效果明确等优点;切开复位、膨胀式椎弓根钉系统在恢复椎体高度方面有优势,但创伤较大,远期椎体高度丢失较大。
Objective To explore the optimal surgical management means for osteoporotic the vertebral compression fracture in elderly by comparing between the minimally invasive operations and open operations. Methods A total of 132 patients with osteoporotie vertebral compression fracture in elderly including 35 male and 97 female, aged between 56 and 78 years old （average： 66 years old）, were retrospectively reviewed. Nineteen patients underwent open operation with expansive spine system pedicle screws. Results Back pain was alleviated in 122 patients postoperatively. The period of lying bed postoperatively for patients with percutaneous vertebroplasty ranged from 6 to 8 hours, and for patients with open operations 2 days. All patients obtained satisfactory restoration of vertebral body height confirmed by X- Ray postoperatively. The Cobb angle were corrected from 10° to 30° （average 15°）. The postoperative follow - up ranged from 6 to 36 months. No back pain recurred. There was no height lost for operated vertebral body in group of percutaneous vertebroplasty while there was partial height lost in group of open performances. Conclusion For the osteoporotic vertebral compression fracture, percutaneous vertebroplasty is effective with minimally invasive operations and easy to perform. The open operation with expansive spine system pedicle screws is superior in restoration of vertebral body height, but eompanied with significant trauma and partial height lost for operated vertebral body at long term follow - up.
出处
《中国骨与关节损伤杂志》
2007年第11期890-892,共3页
Chinese Journal of Bone and Joint Injury
关键词
经皮椎体成形术
膨胀式椎弓根钉
骨质疏松
脊柱骨折
Pereutaneous vertebroplasty
Expansive spine system pedicle screws
Osteoporosis
Spinal fractures
