中国组织工程研究 ›› 2012, Vol. 16 ›› Issue (52): 9873-9880.doi: 10.3969/j.issn.2095-4344.2012.52.033

• 骨与关节临床实践 clinical practice of the bone and joint • 上一篇    

经皮椎体成形治疗陈旧性老年骨质疏松性椎体骨折

信维伟,程光齐,冯 宇,陈 滨   

  1. 上海交通大学医学院附属仁济医院骨科,上海市 200127
  • 收稿日期:2012-09-14 修回日期:2012-10-22 出版日期:2012-12-23 发布日期:2012-12-23
  • 通讯作者: 程光齐,副教授,上海交通大学医学院附属仁济医院骨科,上海市 200127 qiheweibo@163.com
  • 作者简介:信维伟★,男,1979年生,安徽省合肥市人,汉族,2005年上海第二医科大学毕业,硕士,主治医师,主要从事创伤外科方面的研究。 xinww2012@163.com

Percutaneous vertebroplasty for the treatment of old symptomatic osteoporotic vertebral fracture in the elderly

Xin Wei-wei, Cheng Guang-qi, Feng Yu, Chen Bin   

  1. Department of Orthopedics, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
  • Received:2012-09-14 Revised:2012-10-22 Online:2012-12-23 Published:2012-12-23
  • Contact: Cheng Guang-qi, Associate professor, Department of Orthopedics, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China qiheweibo@163.com
  • About author:Xin Wei-wei★, Master, Attending physician, Department of Orthopedics, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China xinww2012@163.com

摘要:

背景:对于经皮椎体成形治疗骨质疏松性椎体骨折研究多基于新鲜性骨质疏松性椎体压缩性骨折,而对陈旧性老年骨质疏松性椎体骨折的治疗鲜有报道。
目的:评价经皮椎体成形治疗陈旧性老年骨质疏松性椎体骨折的疗效。
方法:纳入2007年1月至2010年12月上海交通大学医学院附属仁济医院收治的陈旧性老年骨质疏松性椎体骨折患者,所有12例患者(14椎)均采经皮椎体成形治疗。记录患者经皮椎体成形前、经皮椎体成形后1个月和1年时的疼痛目测类比评分、Oswestry功能障碍索引和站立位侧位片病椎Cobb角。
结果与结论:所有陈旧性老年骨质疏松性椎体骨折患者未发生感染、肺栓塞、骨水泥毒性反应和骨水泥渗漏而造成的神经压迫症状等并发症。经皮椎体成形后失访1例,死亡1例,死亡原因与手术无关。陈旧性老年骨质疏松性椎体骨折患者经皮椎体成形后疼痛目测类比评分和Oswestry功能障碍索引评分均显著低于经皮椎体成形前(P < 0.01),而经皮椎体成形前后患者病椎Cobb角差异无显著性意义(P > 0.05)。提示经皮椎体成形能明显缓解陈旧性骨质疏松性椎体骨折患者的疼痛、改善了患者的生活质量。

关键词: 经皮椎体成形, 陈旧性老年骨质疏松性椎体骨折, 骨质疏松, 椎体骨折, 疼痛目测类比评分, Oswestry功能障碍索引评分, Cobb角, 骨水泥, 生物材料, 骨科植入物

Abstract:

BACKGROUND: The researches on the treatment of osteoporotic vertebral fractures by percutaneous vertebroplasty are mainly based on the fresh osteoporotic compression vertebral fractures, and the reports on the treatment of old symptomatic osteoporotic vertebral fractures are rare.
OBJECTIVE: To investigate the effect of percutaneous vertebroplasty in the treatment of old symptomatic osteoporotic vertebral fractures in elderly.
METHODS: The patients with old symptomatic osteoporotic vertebral fractures in elderly were selected from Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine during January 2007 to December 2010, and all the 12 patients (14 vertebras) were treated with percutaneous vertebroplasty. The Visual Analogue Scale score, Oswestry disability index and local sagittal Cobb’s angles were measured before percutaneous vertebroplasty, and 1 month and 1 year after percutaneous vertebroplasty.
RESULTS AND CONCLUSION: There was no infection, toxic effect of bone cement, pulmonary embolism or leakage of bone cement in the patients with old symptomatic osteoporotic vertebral fractures. After percutaneous vertebroplasty, there was one case with loss of follow-up, one case of death, and the death has nothing to do with the surgery. The Visual Analogue Scale score and Oswestry disability index of the patients with old symptomatic osteoporotic vertebral fractures after percutaneous vertebroplasty were significantly lower than those before percutaneous vertebroplasty (P < 0.01), and there was no significant difference of local sagittal Cobb’s angles before and after percutaneous vertebroplasty (P > 0.05). It suggests that percutaneous vertebroplasty can relieve the pain and improve the life quality of the patients with old symptomatic osteoporotic vertebral fractures.

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