经皮椎弓根穿刺椎体支柱块植入治疗老年胸腰椎压缩性骨折  

Percutaneous pedicle puncture and vertebral body pillar block implant in the treatment of senile thoracolumbar vertebral compression fractures

作　　者：宋成[1] 李亮[1] 李光淳[1] 张利恒[1] 

机构地区：[1]吉林省人民医院,130021

出　　处：《中国实用医药》2015年第29期6-8,共3页China Practical Medicine

摘　　要：目的：探讨经皮椎弓根穿刺椎体支柱块植入治疗老年胸腰椎压缩性骨折的临床效果。方法老年胸腰椎压缩性骨折患者28例,采用经皮椎弓根穿刺椎体支柱块植入治疗,观察临床疗效。结果28个椎体共56枚椎体支柱块,均顺利完成手术,平均手术时间（60±10）min,平均术中失血量（46±15）ml,术后CT检查13例患者椎弓根皮质有破裂,其中外侧皮质破裂11例,内侧皮质破裂2例,均无明显神经症状。术后均获得随访,随访时间12~20个月,平均随访（18.2＆#177;2.6）个月,术后各随访时间点伤椎节段后凸Cobb角、伤椎椎间高度、视觉模拟评分（VAS评分）均较术前明显改善,差异有统计学意义（P〈0.05）,术后3~4个月椎弓根破裂皮质均自行愈合。结论在严格掌握手术适应证前提下,经皮椎弓根穿刺椎体支柱块植入治疗老年胸腰椎压缩性骨折具有手术时间短、出血少、椎体复位满意等优点,近期疗效满意。Objective To investigate clinical effect by percutaneous pedicle puncture and vertebral body pillar block implant in the treatment of senile thoracolumbar vertebral compression fractures.Methods There were 28 senile thoracolumbar vertebral compression fractures patients receiving percutaneous pedicle puncture and vertebral body pillar block implant for treatment. Their clinical effects were observed.Results A total of 28 vertebral bodies, as 56 vertebral body pillar blocks, received successful surgery. Their average operation time was （60±10） min, and average intraoperative bleeding volume was （46±15）ml. Postoperative CT examination showed 13 cases with broken pedicle cortex, as 11 broken lateral cortex cases and 2 broken interior cortex cases,without any obvious neurological sign. All cases received postoperative follow-up for 12~20 months, with the average time as （18.2±2.6） months. After operation, injured vertebral segment kyphotic Cobb angle, injured intervertebral height, and visual analogue scale （VAS） score at every time points were all remarkably improved. Their difference had statistical significance （P〈0.05）. In 3~4 months after operation, all broken pedicle cortex healed.Conclusion Implement of percutaneous pedicle puncture and vertebral body pillar block implant in the treatment of senile thoracolumbar vertebral compression fractures under strict control of operative indication contains advantages of short operation time, few hemorrhage, and satisfactory vertebrae reduction. This method provides satisfactory short-term curative effect.

关 键 词：经皮椎弓根穿刺 椎体支柱块 胸腰椎压缩性骨折 

分 类 号：R687.3[医药卫生—骨科学]