体位复位后微量骨水泥注入椎体成形术治疗老年骨质疏松性胸椎椎体骨折  

Vertebroplasty With Micro-amount of Bone Cement Injection After Postural Reduction for the Treatment of Senile Osteoporotic Thoracic Vertebral Fractures

作　　者：胡天瑞 吴博文 胡安文[2] 曹纬 张振兴[2] Hu Tianrui;Wu Bowen;Hu Anwen(Department of Spinal Surgery, First People’s Hospital of Huaihua Affiliated to Nanhua University, Huaihua 418000, China)

机构地区：[1]南华大学衡阳医学院,衡阳421001 [2]南华大学附属怀化市第一人民医院脊柱外科,怀化418000

出　　处：《中国微创外科杂志》2021年第10期918-922,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨体位复位后微量骨水泥注入经皮穿刺椎体成形术(percutaneous vertebro plasty,PVP)治疗老年骨质疏松性胸椎椎体骨折的疗效。方法2014年1月~2020年1月,对60例老年骨质疏松性胸椎椎体骨折行PVP,椎体高度压缩<1/2。体位复位后C臂X线机定位骨折线区域,透视下注入骨水泥1~3 ml,使其弥散到椎体骨折区域。观察术中骨水泥渗漏发生率,术前、术后3天、末次随访时疼痛视觉模拟评分(Visual Analogue Scale,VAS)、伤椎椎体前缘和中间高度变化。结果60例手术均成功,骨水泥注射量1.0~3.0 ml,平均2.1 ml,术中无骨水泥渗漏,术后胸背部疼痛症状均缓解。术后随访6~26个月,平均12个月。术后3天疼痛VAS评分较术前明显降低,伤椎椎体前缘、中间高度较术前明显增加(P<0.05),末次随访与术后3 d比较无统计学差异(P>0.05),邻椎无骨折。结论体位复位后微量骨水泥注入PVP能消除疼痛,恢复椎体高度,并发症少,是治疗老年骨质疏松性胸椎椎体骨折的较好方法。Objective To investigate the effect of percutaneous vertebroplasty(PVP)with micro-amount bone cement injection after postural reduction in the treatment of senile osteoporotic thoracic vertebral fractures.Methods From January 2014 to January 2020,60 elderly patients with osteoporotic thoracic vertebral fractures underwent PVP.The vertebral height compression was less than 1/2.After postural reduction,the fracture line area was located by C-arm X-ray machine,and 1-3 ml of bone cement was injected under fluoroscopy to diffuse the mud to the fracture area of the vertebral body.The incidence of intraoperative bone cement leakage,Visual Analogue Scale(VAS)of pain before operation,3 days after operation and at the last follow-up,and the changes of anterior and middle height of injured vertebral bodies were observed.Results The operation was successful in all the 60 cases.The average volume of bone cement injected into the thoracic vertebrae was 2.1 ml(range,1.0-3.0 ml).No leakage of bone cement occurred during the operation,and the symptoms of chest and back pain relieved after the operation.The patients were followed up for 6-26 months(average,12 months).At 3 days after surgery,the VAS score and anterior and middle height of injured vertebral bodies were significantly improved(P<0.05),and no significantly change were found at the last follow-up(P>0.05).There was no fracture of adjacent vertebral body during the follow-up period.Conclusions After reduction of body position,micro-amount bone cement injection into vertebroplasty can eliminate pain,recover vertebral height and reduce complications.It is a good method for the treatment of senile osteoporotic fracture of thoracic vertebrae.

关 键 词：体位复位 微量骨水泥 胸椎椎体骨折 

分 类 号：R68[医药卫生—骨科学]