经皮椎体成形术治疗陈旧性胸腰椎压缩性不愈合骨折的临床应用  

Clinical application of percutaneous vertebroplasty in the treatment of obsolete thoracic and lumbar compression fractures

作　　者：罗涛[1] 尹豫 步建立 钱宇航 王文静 LUO Tao;YIN Yu;BU Jianli;QIAN Yuhang;WANG Wenjing(Ward 1 of Orthopedics,the 980th Hospital(Bethune International Peace Hospital)of the PLA,Shijiazhuang 050032,China;The Second Department of Orthopedics,the First Affiliated Hospital of Hebei Medical University)

机构地区：[1]中国人民解放军联勤保障部队第九八○医院(白求恩国际和平医院)骨科1病区,河北石家庄050032 [2]河北省医科大学第一附属医院骨二科

出　　处：《包头医学院学报》2021年第9期39-42,共4页Journal of Baotou Medical College

摘　　要：目的:评估精准定向穿刺椎体成形术治疗胸腰段陈旧性不愈合骨折的临床治疗效果。方法:2015年1月至2020年7月,对47例不愈合的陈旧性胸腰椎体骨折患者行精准定向穿刺椎体成形术治疗。测量患者术前、术后3 d、术后3个月、术后6个月及术后1年病椎前缘压缩率、功能障碍指数(Oswestry disability index,ODI)、疼痛视觉模拟评分(visual analogue scale,VAS)来评价治疗的效果。结果:患者术后椎体前缘压缩率较术前改善,差异有统计学意义(P<0.05)。患者的术后VAS和ODI评分均优于术前,差异有统计学意义(P<0.05)。结论:对于不愈合的陈旧性胸腰椎骨折,通过术前计算骨折不愈合区域面积、术中精准定向穿刺、准确控制注射骨水泥到骨折不愈合位置、精确控制骨水泥注入量,增加了病椎的刚度和强度,能明显减轻疼痛症状并提高患者的生活品质。Objective:To evaluate the clinical treatment effect of precisely targeted puncture vertebroplasty in the treatment of old non-healing fractures in thoracic and lumbar segments.Methods:From January 2015 to July 2020,47 patients were treated with precisely targeted puncture vertebroplasty,with the compression rate of the anterior margin of the vertebrae,visual analogue scales(VAS)and Oswestry disability indexes(ODI)measured before operation,3 d after operation,3 months after operation,6 months after operation and 1 year after operation measured to evaluate the effect of treatment.Results:The postoperative vertebral anterior margin compression rate was significantly improved,the difference being statistically significant(P<0.05).The patients had better postoperative VAS and ODI scores,the difference being statistically significant(P<0.05).Conclusion:For the old thoracic and lumbar fracture,precisely targeted puncture,calculating the non-healing areas of fractures before operation,and accurate controlling the amount of bone cement injection into the non-healing position increase the stiffness and strength of the diseased vertebra,which can significantly reduce pain and improve the patient's quality of life.

关 键 词：胸腰椎陈旧性骨折 不愈合 精准定向穿刺 经皮椎体成形术 

分 类 号：R68[医药卫生—骨科学]