[1]田明* 韩晓斌 李玉民.经皮椎体成形术治疗全身骨显像诊断老年骨质疏松性新发椎体隐匿性骨折[J].中国微创外科杂志,2022,01(12):939-944.
　Tian Ming,Han Xiaobin,Li Yumin..Percutaneous Vertebroplasty in the Treatment of Osteoporotic New Occult Vertebral Fracture Diagnosed by Bone Scan Imaging in Elderly Patients[J].Chinese Journal of Minimally Invasive Surgery,2022,01(12):939-944.
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经皮椎体成形术治疗全身骨显像诊断老年骨质疏松性新发椎体隐匿性骨折()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2022年12期
页码:
939-944
栏目:
临床研究
出版日期:
2023-03-13

文章信息/Info

Title:
Percutaneous Vertebroplasty in the Treatment of Osteoporotic New Occult Vertebral Fracture Diagnosed by Bone Scan Imaging in Elderly Patients
作者:
田明* 韩晓斌 李玉民
(民航总医院骨科，北京100123)
Author(s):
Tian Ming;  Han Xiaobin;  Li Yumin.
Department of Orthopedics, Civil Aviation General Hospital, Beijing 100123, China
关键词:
经皮椎体成形术; 骨扫描; 骨质疏松性椎体骨折; 隐匿性骨折
Keywords:
Percutaneous vertebroplasty; Bone scan; Osteoporotic vertebral fracture; Occult fracture
文献标志码:
A
摘要:
目的探讨经皮椎体成形术治疗老年骨质疏松性新发椎体隐匿性骨折的疗效。方法2016年1月~2018年12月我科对44例(46节椎体)骨显像诊断骨质疏松性新发椎体隐匿性骨折行经皮椎体成形术(percutaneous vertebroplasty，PVP)。经皮肤椎弓根进针，透视下将穿刺针穿至椎体中前1/3处，将处于拉丝期的骨水泥注入椎体，透视下观察骨水泥的分布，满意无渗漏后完成手术。采用视觉模拟评分(Visual Analogue Scale，VAS)和Oswestry 功能障碍指数(Oswestry Disability Index，ODI)评估患者疼痛及脊椎功能情况，X线评估伤椎椎体形态学变化。结果44例PVP穿刺全部成功，均无渗漏、肺栓塞等并发症发生。术后1 d 和1、3、6个月VAS评分分别为(2.5±0.8)、(2.4±0.5)、(2.2±0.4)、(2.6±0.7)分，明显低于术前(7.0±0.9)分(均P=0.000)。术后1 d和1、3、6个月ODI分别为 (31.27±3.52)%、(29.27±4.18)%、(29.91±406)%、(3064±388)%，明显低于术前(7502±767)%(均P=0000)。术后1 d和1、3、6个月椎体前缘高度分别为(2884±334)、(2863±342)、(2879±326)、(2862±331) mm，与术前(2885±336)mm比较差异无统计学意义(F=0922，P=0460)。术后1 d和1、3、6个月椎体后缘高度分别为(3140±396)、(3118±374)、(3123±381)、(3125±391) mm，与术前(3141±397)mm比较差异无统计学意义(F=0449，P=0773)。结论PVP治疗老年骨质疏松性新发椎体隐匿性骨折，可迅速减轻疼痛，改善脊椎功能，预防椎体进一步楔形变及脊椎后凸畸形的发生。
Abstract:
ObjectiveTo assess the efficacy of percutaneous vertebroplasty (PVP) for new occult osteoporotic vertebral fractures in elderly patients.MethodsA total of 44 cases (46 vertebrae) of new occult osteoporotic vertebral fracture in elderly patients were diagnosed by bone scan imaging and received the operation of PVP from January 2016 to December 2018. The puncture needle was inserted in the pedicle of the vertebral arch through the skin. Under fluoroscopy, the puncture needle was penetrated to the middle and front 1/3 of the vertebral body. The bone cement in the wiredrawing stage was injected into the vertebral body. The distribution of bone cement was observed under fluoroscopy. The operation was completed after no leakage was observed. The Visual Analogue Scale (VAS) score and Oswestry Disability Index (ODI) were used to evaluate the pain and spinal function of patients, and the Xray examination was used to evaluate the morphological changes of injured vertebral bodies.ResultsThe PVP puncture was successful in all the 44 cases, without leakage, pulmonary embolism or other complications. The VAS scores were (2.5±0.8), (24±0.5), (2.2±0.4), and (2.6±0.7) points at 1 day and 1, 3, and 6 months after operation, respectively, which were significantly lower than those before operation ［(7.0 ± 0.9) points, all P=0.000］. The ODI was (31.27±3.52)%, (29.27±4.18)%, (2991±4.06)%, and (30.64±3.88)% at 1 day and 1, 3, and 6 months after operation, respectively, which were significantly lower than that before operation ［(7502 ± 7.67)%, all P=0.000］. The height of the anterior edge of the vertebral body was (2884±3.34) mm, (28.63±342) mm, (28.79±3.26) mm, and (28.62± 3.31) mm at 1 day and 1, 3, and 6 months after operation, respectively, and there was no significant difference as compared with that before operation ［(28.85±3.36) mm, F=0922, P=0.460］. The posterior edge height of the vertebral body was (31.40±3.96) mm, (31.18±3.74) mm, (31.23±3.81) mm, and (31.25±3.91) mm at 1 day and 1, 3, and 6 months after operation, respectively, and there was no significant difference as compared with that before operation ［(31.41±3.97) mm, F=0.449, P=0.773］.ConclusionUse of PVP for the treatment of occult osteoporotic vertebral fractures in elderly patients can rapidly relieve pain, improve spinal function, and prevent further wedgeshaped deformation and kyphosis.

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备注/Memo

备注/Memo:
*通讯作者，Email：tianming969@aliyun.com
更新日期/Last Update: 2023-03-13