经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折不愈合.pdf

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1、医学l临床研究2014年6月第31卷第6期JClinRes，Jun．2014，Vol31，No6·论著·经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折不愈合唐朝阳张保亮肖东民姜德红唐海军(南华大学附属永州市中心医院脊柱外科，湖南永州425100)[摘要]【目的】探讨经皮穿刺椎体成形术(PVP)在骨质疏松性椎体压缩性骨折(OVCF)不愈合诊治中的可行性和有效性。【方法12009年5月至2013年5月，采用PVP治疗0VCF不愈合患者7例，手术前后患者均行X线片、CT和MRI检查。采用疼痛视觉模拟评分(VA

2、s)，椎体前缘高度变化(AH)和楔形成角(wA)评估手术效果。【结果】7例均顺利完成手术，无严重并发症发生。所有患者均获随访，平均随访时间15．5(5～35)个月；术后疼痛明显减轻或消失，疼痛VAS术前8．1O士1．5O分，术后d。为1．25土1．O4分，两者比较差异有统计学意义(P0．05)。术后AH及WA较术前均无明显改善(P>0．05)；末次随访与术后比较亦无明显差异(P>0．05)。【结论】PVP能明显改善0VC

3、F不愈合引起的腰背部疼痛，对伤雄高度恢复无明显影响。[关键词]骨质疏松；脊柱骨折／外科学；椎体成形术PercutaneousVertebroplastyforthe]i'eatmentofNonunionofOsteolmmticVertebralCompressionFractureTANGZha~yang，ZHANGBa~liang，XIAODong-min，al(DepartmentofSpinalSurgery，theCentralHospitalofYongzhouA}{tliatedtoNa

4、nhuaUniversity，Yongzhou425100，China[Abstract][Objective]Toexplorethefeasibilityandcliniealefficacyofpercutaneousvertebroplasty(PVP)inthediagnosisandtreatmentofnonunionofosteoporoticvertebralcompressionfracture(OVCF)．[Methods]Atotalof7patientswithnonunion

5、ofosteoporoticvertebra1fracturesundergoingPVPfromMay2009toMay2013wereanalyzedretr0spectively．Therewere2malesand5females．Themeanagewas72．5years(61～88years)．Thefracturevertebraewere3casesinT12，3casesinL1and1caseinL2．Thediseasedurationwas15——23months．Allpat

6、ientsreceivedX-rays，CTandMRIexamination．Thesurgicalresultwasevaluatedbyvisualanaloguescale(VAS)，anteriorvertebralheight(AH)andwedgeangle(WA)．[Results]Allpatientswereoperatedsuccessfullywithoutseverecomplications．Al1patientswerefolloweduDfor5～35months(mea

7、n15．5months)．Postoperativepainwasalleviatedobviously．PainVASbeforeandatd1afteroperationwas(8．10土1．50)and(1_25土1．04)respectively，andtherewassignificantdifferencebetweenthem(P<0．05)．TheVASatfina1followupwas(1．15±0．87)，buttherewasnosignificantdifferencebetw

8、eenthefinalfollowupandpost—operation(P>O．05)．Comparedwithbeforeoperation，AHandWAafteroperationhadnoobviousimprovement(P>0．05)．TherewasnosignificantdifferenceinAHandWAbetweenthefinalfol—lowupandpost—operation(P>0．05)．[Concl