【摘要】：目的：探討單側(cè)橫突入路椎體成形術(shù)(percutaneous vertebroplasty, PVP)聯(lián)合體位復(fù)位治療嚴(yán)重腰椎骨質(zhì)疏松性壓縮骨折(osteoporotic vertebral compression fracture, OVCF)的臨床療效。方法：回顧性分析2012年3月-2014年7月我科收治的45例嚴(yán)重腰椎骨質(zhì)疏松性壓縮骨折,共45個(gè)椎體,均給予單側(cè)橫突入路椎體成形術(shù)聯(lián)合體位復(fù)位治療,其中男11例,女34例；年齡60-93歲,平均74.38歲。比較患者術(shù)前、術(shù)后3天及末次隨訪時(shí)疼痛視覺模擬評(píng)分(visual analogue scale,VAS), Oswestry功能障礙指數(shù)(Oswestry disability index, ODI),傷椎Cobb角及椎體前緣、中份高度,評(píng)價(jià)其臨床療效。結(jié)果：順利完成所有患病椎體的手術(shù),手術(shù)時(shí)間29.84±7.73分鐘,骨水泥量5.1±0.97 ml,骨水泥滲漏發(fā)生率15.6%(共7例),無相關(guān)臨床癥狀及體征,39例患者獲得滿意隨訪,失訪6例,失訪率13.3%,隨訪時(shí)間6-30個(gè)月,平均18.2個(gè)月,術(shù)后3天VAS評(píng)分為2.28±0.89分,ODI指數(shù)為33.95±4.44%,Cobb角為8.13±1.69°,傷椎前緣及中份高度分別為24.82±2.52mm、22.77±2.06mm;末次隨訪時(shí)VAS評(píng)分為1.73±0.76分,ODI指數(shù)為21.33±4.83%,Cobb角為8.44±1.650,傷椎前緣及中份高度分別為23.92±2.34mm、22.07±2.18mm,術(shù)前、術(shù)后3天及末次隨訪時(shí)VAS評(píng)分及ODI指數(shù)兩相比較均有統(tǒng)計(jì)學(xué)差異(P0.05)；術(shù)后傷椎Cobb角、椎體前緣及中份高度較術(shù)前恢復(fù)明顯(P0.05),末次隨訪時(shí)傷椎Cobb角及椎體前緣、中份高度較術(shù)后3天無明顯改變(P0.05)。結(jié)論：?jiǎn)蝹?cè)橫突入路椎體成形術(shù)聯(lián)合體位復(fù)位能有效的緩解嚴(yán)重腰椎骨質(zhì)疏松性壓縮骨折引起的疼痛,恢復(fù)并維持傷椎的椎體高度,糾正腰椎后凸Cobb角,重建矢狀面平衡,明顯提高生活質(zhì)量,是一種有效、安全、簡(jiǎn)單、經(jīng)濟(jì)的手術(shù)方式。
[Abstract]:Objective: to investigate the clinical effect of unilateral transverse process vertebroplasty (percutaneous vertebroplasty, PVP) combined with reduction in the treatment of severe osteoporotic compression fracture of lumbar vertebrae (osteoporotic vertebral compression fracture, OVCF). Methods: from March 2012 to July 2014, 45 cases of severe osteoporotic compression fractures of the lumbar vertebrae were analyzed retrospectively. All 45 vertebrae were treated with unilateral transverse-process vertebroplasty combined reduction, including 11 males and 34 females. The average age was 74.38 years. To compare the pain visual analogue score (visual analogue scale,VAS), Oswestry) before operation, 3 days after operation and at the last follow-up, (visual analogue scale,VAS), Oswestry dysfunction index (Oswestry disability index, ODI),) was used to evaluate the clinical efficacy of the patients with Cobb angle of vertebrae and the anterior and middle height of vertebral body. Results: the operation time was 29.84 鹵7.73 minutes, and the cement leakage rate was 15.6% (7 cases) with 5. 1 鹵0. 97 ml, bone cement leakage. 39 patients with no related clinical symptoms and signs were followed up satisfactorily and 6 cases were lost. The rate of missing visit was 13.3.The follow-up time was 6-30 months (mean 18.2 months). On the 3rd day after operation, the VAS score was 2.28 鹵0.89 and the ODI index was 33.95 鹵4.44. The Cobb angle was 8.13 鹵1.69 擄, the anterior and middle height of the injured vertebrae were 24.82 鹵2.52 mm and 22.77 鹵2.06 mm respectively, the VAS score was 1.73 鹵0.76 at the last follow-up, and the ODI index of the Cobb angle was 8.44 鹵1.650, the anterior and middle height of the injured vertebra were 23.92 鹵2.34 mm and 22.07 鹵2.18 mm, respectively. There were significant differences in VAS score and ODI index between 3 days and the last follow-up (P0.05), the Cobb angle, anterior and median height of the injured vertebrae recovered significantly (P0.05), the Cobb angle and the anterior edge of the injured vertebra at the last follow-up were significantly higher than those before the operation (P0.05). There was no significant change in median height 3 days after operation (P0.05). Conclusion: unilateral transverse process approach combined with vertebroplasty can effectively relieve the pain caused by severe osteoporotic compression fracture, restore and maintain the height of the injured vertebra, correct the Cobb angle of lumbar kyphosis, and reconstruct the sagittal balance. It is an effective, safe, simple and economical way to improve the quality of life.
【學(xué)位授予單位】：重慶醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R687.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 胡孔足;椎體成形術(shù)后的組織學(xué)變化[J];臨床骨科雜志;2004年04期

2 W.Brinjikji;B.A.Comstock;P.J.Heagerty;J.G.Jarvik;D.F.Kallmes;葛傳彪;;椎體成形術(shù)的功效與安全性的調(diào)查研究:設(shè)盲效力的詳細(xì)分析[J];國(guó)際醫(yī)學(xué)放射學(xué)雜志;2010年06期

3 鄭楊;;椎體成形術(shù)治療老年腰背彎曲[J];健康博覽;2006年08期

4 徐寶山,唐天駟;椎體成形術(shù)的現(xiàn)狀與發(fā)展方向[J];中華骨科雜志;2001年08期

5 趙必增;椎體成形術(shù)及其進(jìn)展[J];骨與關(guān)節(jié)損傷雜志;2001年06期

6 陸儉,唐天駟,楊惠林;椎體成形術(shù)治療骨質(zhì)疏松性椎體壓縮骨折的進(jìn)展[J];中國(guó)脊柱脊髓雜志;2002年04期

7 滕海軍,周躍;椎體成形術(shù)和后凸成形術(shù)[J];中國(guó)矯形外科雜志;2003年01期

8 滕海軍,周躍,初同偉;椎體成形術(shù)中心肺功能變化的實(shí)驗(yàn)研究[J];中國(guó)脊柱脊髓雜志;2003年09期

9 徐楊,陳統(tǒng)一;椎體成形術(shù)的研究進(jìn)展和發(fā)展方向[J];復(fù)旦學(xué)報(bào)(醫(yī)學(xué)版);2003年05期

10 田云虎,劉亞,邵連芹,朱兵,李忠玉;椎體成形術(shù)中骨水泥量對(duì)椎體機(jī)械性能的影響[J];濰坊醫(yī)學(xué)院學(xué)報(bào);2004年04期

相關(guān)會(huì)議論文 前10條

1 魏紅沁;邵將;賈連順;;椎體成形術(shù)的現(xiàn)代概念[A];2009第十七屆全國(guó)中西醫(yī)結(jié)合骨傷科學(xué)術(shù)研討會(huì)論文匯編[C];2009年

2 陳錦平;;椎體成形術(shù)中的應(yīng)注意問題及相關(guān)進(jìn)展[A];2011年浙江省骨科學(xué)學(xué)術(shù)年會(huì)暨骨關(guān)節(jié)創(chuàng)傷診治新進(jìn)展學(xué)習(xí)班資料集[C];2011年

3 何偉濤;孫金，

本文編號(hào)：2203959