[1]杨惠林　 Hansen A.Yuan①　 陆俭　 陈亮　 倪才方②　 唐天驷.脊柱压缩骨折微创治疗的初步报告[J].中国微创外科杂志,2004,04(6):516-518.
　Yang Huilin,Hansen A. Yuan,Lu Jian,et al.Minimally invasive therapy for vertebral compression fractures[J].Chinese Journal of Minimally Invasive Surgery,2004,04(6):516-518.
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脊柱压缩骨折微创治疗的初步报告
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
04
期数:
2004年6期
页码:
516-518
栏目:
出版日期:
2004-06-30

文章信息/Info

Title:
Minimally invasive therapy for vertebral compression fractures
作者:
杨惠林　 Hansen A.Yuan①　 陆俭　 陈亮　 倪才方②　 唐天驷
苏州大学附属第一医院骨科,苏州,215006
Author(s):
Yang Huilin;  Hansen A. Yuan;  Lu Jian;  et al.
Department of Orthopedics, First AffiliatedHospital ofSuzhou University, Suzhou215006, China
关键词:
椎体成形术;  球囊;  后凸成形术;  脊柱压缩骨折
Keywords:
Vertebroplasty; 　Balloon; 　Kyphoplasty; 　Vertebral compression fracture
分类号:
R683.2
文献标志码:
A
摘要:
目的探讨椎体成形术及椎体后凸成形术治疗脊柱压缩骨折(vertebral compression fractures,VCF)的初步疗效和安全性. 方法 2000年5月～2002年10月分别采用椎体成形术(vertebroplasty,VP)及椎体后凸成形术(kyphoplasty,KP)治疗脊柱压缩骨折43例69椎,分别为椎体后壁完整的疼痛性骨质疏松性压缩骨折及椎体血管瘤导致的椎体压缩骨折.先经双侧椎弓根或椎弓根旁置入导针或可扩张球囊使骨折塌陷椎体复位,然后骨水泥充填椎体,观察术后症状改善及骨折复位情况,分析并发症. 结果 43例手术均顺利,疼痛于术后48 h内均明显缓解.VP组椎体高度无明显改变,KP组骨折椎体前缘和中部高度的丢失分别由术前的(13.6±2.3)mm和(9.2±1.4)mm减少至(4.7±1.5)mm和(3.4±1.1)mm(t=2.85,3.27;P<0.01),后凸畸形Cobb角由术前的24.4°±5.2°矫正至9.5°±4.7°(t=3.21,P<0.01).1例一侧术中穿刺管内出现脑脊液,该侧当即停止手术.未发现其他严重并发症.随访3～28个月,平均13个月,SF-36评分由术前(187.5±10.3)分恢复至术后(376.4±15.9)分(t=4.36,P<0.01). 结论椎体成形术及椎体后凸成形术可迅速、有效缓解疼痛,改善功能,椎体后凸成形术可更有效地恢复脊柱序列.
Abstract:
Objective　To evaluate the initial efficacy and safety of vertebroplasty (VP) and kyphoplasty (KP) in the treatment of vertebral compression fractures (VCF).　Methods　VP and KP were performed in 43 patients with VCF (69 vertebrae), including painful osteoporotic compression fractureswith intact posterior vertebral bodywall and painful VCF resulted from vertebral hemangioma, fromMay 2000 to October 2002. Each procedure included bilateral insertion of guide needle or inflatable balloon through or by the pedicle of vertebral arch, fracture reduction, and bone cement augmentation. Postoperative symptomatic improvement, fracture reduction, and complications were recorded and analyzed.　Results　Operations in all the 43 patients were completed smoothly, and immediate relief of their back pain was achieved within 48 postoperative hours. No change was found in vertebral heights in patients receiving VP, while in patients receiving KP, the loss of anterior and middle vertebral heights had dwindled from (13·6±2·3) mm and (9·2±1·4) mm preoperatively to (4·7±1·5) mm and (3·4±1·1) mm postoperatively (t=2·85 and 3·27;P<0·01), and the kyphosis Cobb angles were corrected from 24·4°±5·2° preoperatively to 9·5°±4·7°postoperatively (t=3·21,P<0·01). Because unilateral cerebrospinal fluid leakage occurred in 1 case, the operation on this sidewas terminated immediately. No other serious complicationswere found. Follow-up checkups for3~28 months (mean, 13 months) revealed that the mean SF-36 scoreswere elevated from 187·5±10·3 preoperatively to 376·4±15·9 postoperatively (t=4·36; P<0·01).　Conclusions　Both vertebroplasty and kyphoplasty can provide quick relief of pain and improvement of function, while the latter can recover the spinal alignment more effectively.

参考文献/References:

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备注/Memo

备注/Memo:
①（State University of New York,Upstate Medical University,Syracuse,New York,USA 13210）②介入放射科
更新日期/Last Update: 2014-06-09