[1]陈雯,马俊明,莫文.骨水泥联合Genex人工骨经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折[J].中医正骨,2018,30(06):40-43.
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骨水泥联合Genex人工骨经皮椎体后凸成形术治疗骨质疏松性 胸腰椎压缩性骨折()
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《中医正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期数:
2018年06期
页码:
40-43
栏目:
临床报道
出版日期:
2018-06-20

文章信息/Info

作者:
陈雯; 马俊明; 莫文
上海中医药大学附属龙华医院,上海 200032
关键词:
脊柱骨折;  骨质疏松性骨折;  胸椎;  腰椎;  椎体后凸成形术;  骨水泥;  Genex人工骨
文献标志码:
A
摘要:
目的:探讨骨水泥联合Genex人工骨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性胸腰椎压缩性骨折的临床疗效及安全性。方法:2014年8月至2016年9月,采用骨水泥联合Genex人工骨PKP治疗骨质疏松性胸腰椎压缩性骨折患者91例,男20例、女71例; 年龄60～92岁,中位数70岁。单节段骨折85例,其中T92例、T105例、T1110例、T1219例、L124例、L213例、L38例、L44例; 双节段骨折6例,其中T11～T122例,T12～L14例。受伤至手术时间12 h至30 d,中位数15 d。分别在术前和术后7 d、1个月、3个月、6个月时,在X线片上测量伤椎高度及伤椎后凸Cobb角,计算伤椎相对高度比,分别采用疼痛视觉模拟量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)和简明健康状况调查表(short form 36 health survey questionnaire,SF-36)评估患者腰背部疼痛、脊柱功能和生活质量。随访观察并发症发生情况。结果:本组91例均顺利完成手术,手术时间11～34 min,中位数23 min。91例患者均获6个月随访。伤椎高度,术前(16.21±2.08)mm、术后7 d(22.05±2.41)mm、术后1个月(21.68±1.89)mm、术后3个月(20.98±1.88)mm、术后6个月(19.98±1.69)mm; 伤椎相对高度比,术前0.54±0.11、术后7 d 0.86±0.09、术后1个月0.85±0.17、术后3个月0.79±0.21、术后6个月0.84±0.13; 伤椎后凸Cobb角,术前19.18°±3.65°、术后7 d 7.83°±1.31°、术后1个月8.32°±1.71°、术后3个月8.75°±1.81°、术后6个月9.17°±1.93°。腰背部疼痛VAS评分,术前(8.27±1.18)分、术后7 d(3.78±0.81)分、术后1个月(3.18±0.73)分、术后3个月(3.09±0.63)分、术后6个月(2.65±0.37)分; ODI,术前(41.30±5.10)%、术后7 d(24.39±4.62)%、术后1个月(22.30±4.50)%、术后3个月(22.45±4.17)%、术后6个月(22.24±4.34)%; SF-36评分,术前(91.58±21.62)分、术后7 d(115.53±27.12)分、术后1个月(110.17±21.61)分、术后3个月(112.90±23.96)分、术后6个月(111.78±24.53)分。均无骨水泥渗漏、脊髓和神经根损伤、肺栓塞等并发症发生。结论:骨水泥联合Genex人工骨PKP治疗骨质疏松性胸腰椎压缩性骨折,可恢复伤椎高度、矫正脊柱畸形、缓解腰背部疼痛、改善脊柱功能、提高患者生活质量,且并发症少。

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更新日期/Last Update: 2018-10-30