经皮椎体成形术后再发骨折的临床研究  

Clinical Study of New Vertebral Compression Fracture after Percutaneous Vertebroplasty

作　　者：陈昌礼[1] 陈硕[1] 

机构地区：[1]都江堰市医疗中心骨科,四川都江堰611830

出　　处：《四川医学》2015年第3期382-385,共4页Sichuan Medical Journal

摘　　要：目的观察骨质疏松压缩性骨折行椎体成形术后,非手术椎体骨折再次行椎体成形术的安全性和有效性。方法从2008年1月到2013年1月,因骨质疏松症性椎体压缩骨折接受椎体成形术并定期随访的患者共246例(298椎)。术后再发骨折需要手术治疗36例(38椎),其中接受一个椎体成形术的有34例,接受两个椎体成形术的有2例。比较首次及再次行椎体成形术后患者疼痛缓解情况,了解有无并发症发生;比较首次行椎体成形术且未再发椎体骨折的患者(A组)及再发椎体骨折的患者(B组)术前骨密度水平。结果首次与再次行椎体成形术后疼痛视觉类比评分较术前显著降低。A组患者骨密度为(-2.9±0.29),B组患者骨密度水平(-3.2±0.39)。两者差异有统计学意义(P<0.01)。所有患者再次行椎体成形术后均未发生再发手术相关并发症。结论椎体成形术后非手术椎体骨折再次行椎体成形术对于患者疼痛的改善方面与首次治疗效果相当。低骨密度水平是术后再骨折的高危因素。Objective To investigate the safty and efficacy of repeat percutaneous vertebroplasty（ PVP） to treat the new vertebral compression fractures（VCFs）after PVP. Methods From January 2008 to January 2013,246 patients（298 levels）of os-teoporotic VCFs who were regularly followed up had underwent PVP. Among the patients,the second treatment group included 36 patients（38 levels） who developed new VCFs,which were retreated. Analgesic effects and complications were compared between the initial and second treatment groups. Meanwhile,Preoperative bone mineral density（BMD）were compared between the initial treatment group with（group B）and without refracture（group A）. Results The visual analogue scale（VAS）scores after surgery both were significantly lower in the initial and the second treatment group. There was significant difference in BMD between group A（ -2.9±0.29）andgroupB（ -3.2±0.39）（P〈0.01）.Nosurgery-relatedcomplicationsoccurredinpatientswhounderwent the second treatment. Conclusion Repeat PVP should be an effective treatment equal to initial PVP. And lower BMD may be a risk factor of VCFs after PVP.

关 键 词：骨质疏松症 椎体压缩骨折 再骨折 椎体成形术 骨密度 

分 类 号：R687.3[医药卫生—骨科学]