外固定器整复下经皮椎体成形术治疗伤椎后壁破损的骨质疏松性压缩骨折

Evaluation of clinical effect for the treatment of osteoporosis compressive fractures with posterior vertebral defect using percutaneous vertebroplasty combined with the spinal external fixator

中文关键词:  骨质疏松压缩骨折  经皮椎体成形术  脊柱外固定器

英文关键词:Osteoporosis compressive fractures  Percutaneous vertebroplasty  Spine external fixator

中文摘要:

  【摘要】 目的：探讨外固定器整复下经皮椎体成形术治疗伤椎后壁破损的骨质疏松性压缩骨折的临床疗效。方法：2005年1月～2010年1月收治椎体后壁破损的骨质疏松性新鲜压缩骨折患者35例（37个椎体），先行脊柱外固定器整复固定，再行经皮椎体成形术。根据影像学检查，计算患者治疗前后椎体高度丢失率、椎管占位率及后凸角，随访观察临床疗效。结果：椎体前缘高度丢失率术前为75.1%±12.9%，术后为7.5%±6.2%，末次随访时为7.5%±6.3%；椎管占位率术前为17.25%±20.44%，术后为4.34%±5.94%，末次随访时为4.38%±5.96%；后凸角术前为23.5°±8.7°，术后为7.4°±4.3°，末次随访时为7.4°±4.4°。椎体高度丢失率、椎管占位率及后凸角术后、末次随访时较术前均明显改善，差异有统计学意义（P＜0.05）；末次随访时与术后比较差异无显著性（P＞0.05）。出现骨水泥渗漏2例，但无明显症状，未见其他并发症。结论：脊柱外固定器整复下经皮椎体成形术治疗伤椎体后壁破损的骨质疏松性压缩骨折是一种安全有效的治疗方法。

英文摘要:

  【Abstract】　Objective：To explore the clinical effect for the treatment of osteoporosis compressive fractures with posterior vertebral defect using percutaneous vertebroplasty combined with the spinal external fixator.Method：37 vertebrae in 35 patients with fresh severe compressive fractures were treated by using spinal external fixator and filled by bone cement from January 2005 to January 2010.The rate of loss height of the vertebral body and kyphotic angle were measured before and after operation.The bone impingement into the spinal canal was evaluated on the computed tomography.Result：The rate of loss anterior height of the vertebral body was reduced from 75.1%±12.9% to 7.5%±6.2% after operation and 7.5%±6.3% at the last follow-up.The occupancy rate of spinal stenosis was reduced from 17.25%±20.44% to 4.34%±5.94% after operation and 4.38%±5.96% at last follow-up.The Kyphotic angle was corrected from 23.5°±8.7° to 7.4°±4.3° after operation and 7.4°±4.4° at the last follow-up.Statistics compared between preoperation and postoperation were significantly different（Ｐ＜0.05），but between postoperation and last follow-up were not significantly different（Ｐ＞0.05）.Two patients had bone cement leakages.There were no other complications.Conclussion：Spinal external fixator combined with percutaneous vertebroplasty was a safe and effective method to treat the osteoporosis compressive fractures with posterior vertebral defect.