经皮可扩张椎体支柱块置入术治疗胸腰椎压缩骨折  

Percutaneous intravertebral expandable pillar implanting for treatment of thoracolumbar vertebral compression fractures

作　　者：黄智慧[1] 丁亮华[1] 胡新宇[1] 包欣南[1] 张乃东[1] 凌为其[1] 

机构地区：[1]苏州大学附属第三医院骨科,江苏省常州市213003

出　　处：《中国骨与关节损伤杂志》2012年第11期981-983,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的探讨经皮可扩张椎体支柱块（IVEP）置入并植骨治疗胸腰椎压缩性骨折的手术技巧和短期疗效。方法自2009年1月-2011年2月采用经皮穿刺经双侧椎弓根IVEP置人术治疗胸腰椎压缩性骨折42例（44椎），共置入支柱块88枚。结果术后疼痛显著缓解。VAS评分及ODI评分均较术前明显降低。平均手术时间（38．8＋5．3）min／椎。术后椎体高度平均恢复至正常椎体高度的（89．6＋6．5）％，术后Cobb角明显变小。至末次随访，骨折愈合良好，无复位丢失和支柱块移位。结论经皮可扩张IVEP置入并植骨治疗胸腰椎压缩性骨折的短期疗效满意，具有创伤小、手术操作简便、并发症少、并且可保留脊柱生理活动度的优点，是治疗该类骨折较为理想的选择。Objective To study the operation techniques and therapeutic outcomes of percutaneous intravertebral expandable pillar （IVEP） implanting for treatment of thoracolumbar vertebral compression fractures. Methods Between January 2009 and February 2012, forty-two patients with thoracolumbar vertebral compression fractures were treated by percutaneously IVEP implanting and bone grafting through bilateral pedicle. Results Forty-four vertebral bodies were treated in forty-two patients. All patients successfully underwent the surgery without open-surgery or changing internal fixation, The average operation time was （38.8＋5.3）rain per vertebral body （range, 25±45 min）. Pain was prominently relieved the next day after operation. The VAS was （8.2±1.2） before Operation and （2.3±2.1） twenty-four hours after operation. The ODI was （53.2±13.4）% before operation and （24.9±14.7）%. The preoperative loss of vertebral height was 36% and it was reduced to 10% postoperatively. The average Cobb＇s angle was 23 preoperatively and 8 postoperatively. In an average follow up of 13.7 months （range 6±20 months）, there were no loss of reduction and dislocation of IVEP. Conclusion These forty-two cases demonstrate that the IVEP implanting percutaneously along with bone grafting obtained satisfactory clinical outcomes in treatment of thoracolumbar vertebral compression fractures. And it had advantages of minimal invasion, convenience operation, less complications and keeping spine column＇s physiological range of motion. So it should be a better choice for treatment of thoracolumbar compression fractures.

关 键 词：胸腰椎压缩性骨折 椎体支柱块 微创 

分 类 号：R683.2[医药卫生—骨科学]