骨质疏松性椎体骨折不愈合的临床特点与手术方法探讨  

The Clinical features and surgical operation approaches for the nonunion of osteoporotic vertebral compression fractures

作　　者：罗文正[1] 陈诚[1] 唐廷波[1] 

机构地区：[1]永州职业技术学院附属医院脊柱外科,永州425006

出　　处：《中国骨质疏松杂志》2014年第3期269-271,共3页Chinese Journal of Osteoporosis

摘　　要：目的：探讨老年性骨质疏松性椎体骨折不愈合的临床特点与手术方法。方法对11例骨质疏松性椎体骨折不愈合患者的临床表现与影像学特点进行归纳和分析，6例行经皮椎体成形或后凸成形术，5例行开放减压椎弓根系统复位固定直视下椎体成形术。结果11例患者均顺利完成手术，椎体成形或后凸成形术后2～4天，手术后6～7天配带腰背支具下床活动，8例患者椎体高度的恢复和Coob角改善，发生骨水泥漏1例，随访4～11个月，VAS评分由术前的7.5下降到术后3.4，Oswestry评分由术前的76下降到26，未见邻近节段发生再骨折，1例X线可见椎弓根螺钉道扩大。结论该类骨折不愈合有其特殊的临床特点和影像学表现，手术方法应根据其临床特点进行选择。Objective To investigate the clinical features and surgical operation approaches for the nonunion of osteoporotic vertebral fractures in senile patients.Methods The clinical data of 11 patients with osteoporotic vertebral compression fracture nonunion, including clinical manifestations and imaging characteristics, were summarized and analyzed.Six patients were treated by vertebral angioplasty or kyphoplasty, and 5 patients received routine open decompression and reduction fixed vertebral angioplasty. Results All the 11 patients were successfully operated and got out of bed with cocoa belt waist after 2-4 days for patients with vertebroplasty or kyphoplasty, while after 6-7 days for those with routine operation.The vertebral height was restored in 8 patients with the improvement of Cobb angle.Bone cement leakage occurred in 1 patient.After 4-11-month postoperative follow-up, VAS score decreased from preoperative 7.5 to postoperative 3.4, and Oswestry score from preoperative 76 to postoperative 26.No re-fracture of segmental or adjacent segment occurred.The pedicle screw nail was observed in the X-ray image in 1 patient. Conclusion The results suggest that this kind of fracture nonunion has special clinical feature and imaging finding.Surgical operation approach should be selected based on the clinical feature.

关 键 词：骨质疏松性椎体骨折 不愈合 临床特点 手术 

分 类 号：R68[医药卫生—骨科学]