老年骨质疏松性胸腰段椎体骨折伴后凸畸形诊疗指南(2024版)  

Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fracture with kyphotic deformity in the elderly(version 2024)

作　　者：陈建[1] 李青青[1] 顾军 胡志毅[1] 赵书杰 黄振飞 江涛[1] 周炜[1] 曹晓建[1] 任永信[1] 蔡卫华[1] 余利鹏[1] 眭涛[1] 王前[1] 唐鹏宇 武梦圆 马维虎[3] 卢旭华 刘宏建[5] 张忠民[6] 周晓中[7] 贺宝荣[8] 李开南[9] 于腾波 郭晓东[11] 王永祥[12] 海涌[13] 史建刚 徐宝山[14] 李危石[15] 闫景龙[16] 宁广智[17] 郭永飞 乔之军 张峰 王福兵 陈福杨 贾艳[1] 周小花[1] 彭玉慧[1] 凡进[1] 殷国勇[1] 中国医药教育协会脊柱分会腰椎教育工作组 《中华创伤杂志》编辑委员会 Chen Jian;Li Qingqing;Gu Jun;Hu Zhiyi;Zhao Shujie;Huang Zhenfei;Jiang Tao;Zhou Wei;Cao Xiaojian;Ren Yongxin;Cai Weihua;Yu Lipeng;Sui Tao;Wang Qian;Tang Pengyu;Wu Mengyuan;Ma Weihu;Lu Xuhua;Liu Hongjian;Zhang Zhongmin;Zhou Xiaozhong;He Baorong;Li Kainan;Yu Tengbo;Guo Xiaodong;Wang Yongxiang;Hai Yong;Shi Jiangang;Xu Baoshan;Li Weishi;Yan Jinglong;Ning Guangzhi;Guo Yongfei;Qiao Zhijun;Zhang Feng;Wang Fubing;Chen Fuyang;Jia Yan;Zhou Xiaohua;Peng Yuhui;Fan Jin;Yin Guoyong;Lumbar Education Working Group,Spine Branch,Chinese Medicine Education Association;Editorial Committee of Chinese Journal of Trauma(Jiangsu Provincial People′s Hospital(First Affiliated Hospital of Nanjing Medical University),Nanjing 210029,China;Wuxi Xishan People′s Hospital,Wuxi 214105,China;Ningbo Sixth Hospital,Ningbo 315000,China;Second Affiliated Hospital,Naval Medical University,Shanghai 200003,China;First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Second Affiliated Hospital of Soochow University,Suzhou 215004,China;Affiliated Honghui Hospital of Xi′an Jiaotong University,Xi′an 710054,China;Affiliated Hospital of Chengdu University,Chengdu 610031,China;Qingdao Municipal Hospital,Qingdao 266011,China;Union Hospital of Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430022,China;Jiangsu Provincial Northern Jiangsu People′s Hospital,Yangzhou 225001,China;Beijing Chaoyang Hospital,Capital Medical University,Beijing 100020,China;Tianjin Hospital,Tianjin 300211,China;Peking University Third Hospital,Beijing 100191,China;Second Affiliated Hospital of Harbin Medical University,Harbin 150001,China;General Hospital of Tianjin Medical University,Tianjin 300052,China;Liyang People′s Hospital,Changzhou 213376,China;Xuyi County People′s Hospital of Jiangsu Province,Huaian 211700,China;Nanjing Pukou People′s Hospital,Nanjing 211800,China;不详)

机构地区：[1]江苏省人民医院(南京医科大学第一附属医院),南京210029 [2]无锡市锡山人民医院,无锡214105 [3]宁波市第六医院,宁波315000 [4]海军军医大学第二附属医院,上海200003 [5]郑州大学第一附属医院,郑州450052 [6]南方医科大学第三医院,广州510515 [7]苏州大学附属第二医院,苏州215004 [8]西安交通大学附属红会医院,西安710054 [9]成都大学附属医院,成都610031 [10]青岛市市立医院,青岛266011 [11]华中科技大学同济医学院附属协和医院,武汉430022 [12]江苏省苏北人民医院,扬州225001 [13]首都医科大学附属北京朝阳医院,北京100020 [14]天津市天津医院,天津300211 [15]北京大学第三医院,北京100191 [16]哈尔滨医科大学附属第二医院,哈尔滨150001 [17]天津医科大学总医院,天津300052 [18]溧阳市人民医院,常州213376 [19]江苏省盱眙县人民医院,淮安211700 [20]南京市浦口人民医院,南京211800 [21]不详

出　　处：《中华创伤杂志》2024年第11期961-973,共13页Chinese Journal of Trauma

基　　金：国家自然科学基金(82372408,81902211,82030069);江苏省科技厅重大产学研项目(BA2022003);第一期江苏省人民医院高层次人才培育计划(CZ0121002010037,CZ0121002010039)。

摘　　要：老年骨质疏松性胸腰段椎体骨折(OTLVF)发生率逐渐增多,多种因素所致的后凸畸形已经成为OTLVF的重要特征且越发受到关注,临床主要表现为疼痛、迟发性神经损害及矢状面失衡等。目前,老年OTLVF伴后凸畸形的定义和诊断仍不明确,治疗方案较多但争议较大,现有指南或共识对该类骨折伴后凸畸形关注较少。为此,中国医药教育协会脊柱分会腰椎教育工作组和《中华创伤杂志》编辑委员会组织国内相关领域专家,基于循证医学证据,遵循科学性、实用性和先进性原则,制订《老年骨质疏松性胸腰段椎体骨折伴后凸畸形诊疗指南(2024版)》,提出18条推荐意见,以规范其临床诊疗。The incidence of osteoporotic thoracolumbar vertebral fracture(OTLVF)in the elderly is gradually increasing.The kyphotic deformity caused by various factors has become an important characteristic of OTLVF and has received increasing attention.Its clinical manifestations include pain,delayed nerve damage,sagittal imbalance,etc.Currently,the definition and diagnosis of OTLVF with kyphotic deformity in the elderly are still unclear.Although there are many treatment options,they are controversial.Existing guidelines or consensuses pay little attention to this type of fracture with kyphotic deformity.To this end,the Lumbar Education Working Group of the Spine Branch of the Chinese Medicine Education Association and Editorial Committee of Chinese Journal of Trauma organized the experts in the relevant fields to jointly develop Clinical guidelines for the diagnosis and treatment of osteoporotic thoracolumbar vertebral fractures with kyphotic deformity in the elderly(version 2024),based on evidence‑based medical advancements and the principles of scientificity,practicality,and advanced nature,which provided 18 recommendations to standardize the clinical diagnosis and treatment.

关 键 词：骨质疏松 脊柱骨折 脊柱后凸 胸椎 腰椎 老年人 

分 类 号：R580[医药卫生—内分泌] R682.3[医药卫生—内科学] R683.2[医药卫生—临床医学]