采用MRI结合DR片定位规范数字化PKP/PVP术快速康复治疗老年胸腰骶椎骨折  

Rapid rehabilitation of elderly patients with thoracic and lumbar and sacral fractures by MRI combined with DR positioning and standardized digital PKP/PVP

作　　者：汤长华[1] 杨惠林[2] 张晓慧[1] 冯国新[1] 叶志远 张杰[1] 朱永敢 Tang Changhua;Yang Huilin;Zhang Xiaohu;Feng Guoxin;Ye Zhiyuan;Zhang Jie;Zhu Yonggan(Department of orthopedics,Sihong County People's Hospital of Jiangsu Province,Sihong 223900,China;Department of Orthopedics,the First Affiliated Hospital of Soochow University,Suzhou 215006,China)

机构地区：[1]江苏省泗洪县人民医院骨科,223900 [2]苏州大学附属第一医院骨科,215006

出　　处：《中华老年骨科与康复电子杂志》2020年第2期68-73,共6页Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition)

基　　金：国家自然科学基金资助项目(81171689,30672140)。

摘　　要：目的探讨采用MRI结合DR片定位数字化经皮椎体后凸成形术(PKP)/经皮椎体成形术(PVP)快速康复治疗老年胸腰骶椎骨折的疗效.方法回顾性收集江苏省泗洪县人民医院骨科2016年1月至2018年12月采用MRI结合DR片定位数字化PKP/PVP术快速康复治疗T5~S1老年胸腰骶椎骨折患者69例.采用疼痛视觉模拟评分(VAS)进行疼痛评分,X线片测定术前、术后椎体前后缘高度比值及Cobb's角,进行统计学分析,评定疗效.结果随访3~24个月,平均(18±11)个月.术中出血量2~15 ml,平均(5.0±2.1)ml.手术时间30~120 min,平均(55±7)min.术中无脊髓神经损伤,1例陈旧性骨折发生无症状椎间隙人工骨渗漏,2例PMMA椎旁渗漏.疼痛VAS评分由术前的(7.5±0.7)分恢复为术后1个月的(0.7±0.7)分.椎体前后缘高度比值由术前的(62±32)恢复为术后1个月的(94±38).Cobb's角由术前的(16±5)°恢复为术后1个月的(2.6±1.4)°.差异均有统计学意义(P<0.01).结论采用MRI结合DR片定位数字化PKP/PVP术,快速康复治疗老年胸腰骶椎骨折,可降低骨水泥渗漏风险,纠正脊柱后凸畸形,早期下床快速康复锻炼,骨折愈合好.Objective To investigate the effect of rapid rehabilitation of percutaneous kyphoplasty/percutaneous vertebroplasty(PKP/PVP)in the treatment of senile thoracic and lumbar and sacral fractures with MRI combined with DR.Methods From January 2016 to December 2018 in department of orthopedics,Sihong County People's Hospital in Jiangsu Province,69 patients with T5-S1 elderly thoracic and lumbar and sacral fractures were treated with MRI combined with DR imaging and digital PKP/PVP.Pain scores were performed by visual analogue score method.X-ray films were used to measure the ratio of anterior and posterior vertebral heights and cobb angles before and after surgery.Statistical analysis was performed to evaluate the efficacy.Results 69 patients were followed up for 3 to 24 months with an average of 18±11 months.The intraoperative blood loss was 2-15 ml,with an average of 5.0±2.1 ml.The operation time was 30-120 min with an average of 55±7 min.There was no spinal nerve injury during operation,1 case of old fractures had asymptomatic intervertebral space artificial bone leakage,2 cases of PMMA paraspinal leakage.The pain VAS score returned from preoperative 7.5±0.7 points to 0.7±0.7 points one month after operation.The anterior-posterior height ratio of the vertebral body recovered from 62±32 before surgery to 94±38 one month after operation.Cobb’s angle recovered from preoperative 16±5°to 2.6±1.4°one month after operation.The differences were statistically significant(P<0.01).Conclusions MRI combined with DR film positioning digital PKP/PVP rapid rehabilitation treatment of elderly thoracic and lumbar and sacral fractures,can reduce the risk of bone cement leakage,correct kyphosis deformity,obtain early rapid rehabilitation,good fracture healing.

关 键 词：椎体成形术 椎体后凸成形术 核磁共振 数字化 

分 类 号：R687.3[医药卫生—骨科学]