经皮穿刺椎体成形术治疗骨质疏松椎体压缩骨折

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1、158中国骨质疏松杂志　2002年5月第8卷第2期　ChinJOsteoporos,May.2002,Vol8,No.2·临床研究·经皮穿刺椎体成形术治疗骨质疏松椎体 压缩骨折陆军　张贵祥　赵海涛　石梅　韩良甫【摘要】　目的　确定经皮穿刺椎体成形术在治疗疼痛性骨质疏松脊柱压缩骨折中的效用。方法　2年内15例有1～6个月背部、腰部疼痛伴行动障碍需止痛药治疗患者(男5人、女10人),年龄58～81岁,经临床、CT及MRI评价为骨质疏松椎体压缩且近期有进展,在CT引导下完成经皮穿刺椎体成形术22例次。治疗效果采用Huskisson止痛视觉评分法评估。结果　13例患者(8617

2、%)在24h内疼痛缓解,12例停用止痛药,余下的2例有轻微疼痛好转(1313%)。1例患者3个月后由于相邻椎体出现新的压缩而疼痛复发,二次治疗好转。结论　经皮穿刺椎体成形术用于骨质疏松椎体压缩是一种微创操作,可以立即缓解疼痛并使患者很快恢复运动,是一种有价值的治疗骨质疏松压缩骨折的方法。【关键词】　经皮穿刺;　椎体成形术;　骨质疏松;　椎体压缩Treatmentofosteoporoticvertebralcompressionfracturesbypercutaneousvertebroplasty　LUJun,ZHANGGuixiang,ZHAOHaitao,eta

3、l.DepartmentofRadiotherapy,XijingHospital,FourthMilitaryMedicalUniversity,Xi’an710032,China【Abstract】　Objective　Todeterminetheefficacyofpercutaneousvertebroplasty(PVP)intreatingpain2fulosteoporoticvertebralcompressionfractures.Methods　Fifteencasesofvertebralcompressionfracturewere evalua

4、tedwithCTandMRItodetermineosteoporoticoriginandrecentevolution.Twenty2twopercutaneousverte2 broplastieswereperformedusingCTguidance.Thefifteenpatientsincludedinthestudy(5men,10women;58 -81yearsold)hadhadpainforonetosixmonthsthathinderedambulationandrequiredtreatmentwithnarcotic drugs.The

5、analogicvisualscaleofHuskissonwasusedforpaininscoringassessment.Results　In13patients (8617%),painreliefwascompletewithin24hoursafterbonecementinjection.Analgesicadministrationwas stoppedin12patients.Painreliefwasslightintheother2patients.Inthelastpatient,painrecurredthreemonthsafterPVPbe

6、causeofanewacutecollapseofanadjacentvertebra.ItwasrelievedbyasecondPVP. Conclusion　Vertebroplastyforthetreatmentofosteoporoticvertebralcompressionfractureisaminimallyinva2 siveprocedurethatprovidesimmediatepainreliefandenablesthepatientstobecomequicklymobile.PVPisa goodmethodtotreatosteo

7、poroticvertebralcollapse.【Keywords】　Percutaneous;　Vertebroplasty;　Osteoporosis;　Vertebralbodycompression　　随着人口老龄化,患骨质疏松椎体压缩骨折的老龄人口在增加,一些长期应用皮质醇的患者也易材料和方法发生骨折。这些骨折常常引起持续的有时极度的疼11临床资料痛,明显地损害了运动能力和生存质量。近年来,经1999年3月～2001年3月,笔者对15例(10例皮穿刺椎体成形术已经有很大的发展,被广泛地用女,5例男,年龄58～81岁)22个部位