摘要
[目的]探讨经皮椎体后凸成形术治疗新鲜与陈旧性骨质疏松性椎体压缩骨折疗效间的差异性。[方法]对56例骨质疏松性椎体压缩骨折患者的137个椎体行经皮椎体后凸成形术。骨折椎体根据术前MRI上信号强度的改变分为3种类型:Ⅰ型为新鲜型骨折,Ⅱ型为修复型骨折,Ⅲ型为陈旧型骨折,通过观察患者手术前后压缩椎体前缘及中部高度恢复情况、局部Cobb′s角及VAS评分变化情况来评估3种不同类型之间手术疗效的差异。[结果]在经皮椎体后凸成形术后,所有患者的疼痛症状均得到迅速而有效地缓解,VAS评分由术前的8.09±1.12下降为术后的2.31±0.91及随访时的2.26±0.88。所有骨折椎体Ⅰ型41例、Ⅱ型69例、Ⅲ型27例。Ⅰ、Ⅱ型椎体术后各项评估指标较术前有明显改善,而Ⅲ型椎体手术前后各项评估指标没有显著性差异。[结论]经皮椎体后凸成形术对新鲜骨折疗效要明显优于陈旧性骨折,应在发现患者存在压缩骨折后尽早施行手术。
[ Objective] To analyze the therapeutic effects of percutaneous kyphoplasty for acute versus chronic osteoporotic vertebral compressive fracture. [ Method] Percutaneous kyphoplasty was performed in 56 patients （137 vertebraes） with osteoporotic vertebral compression fracture （VCF）. Based on the changes on MRI, all compression fractures were divided into 3 types：acute VCF, repairing VCF and chronic VCF. Types were examined for differences in treatment efficacy, according to the anterior/ middle vertebral body height,Cobb＇s angle and visual analogue scale（VAS） at pre-and post-operation. [ Result] All patients with the VCFs had rapid and significant improvement in back pain following percutaneous kyphoplasty. VAS was from 8.09 ± 1.12 pre- operatively to 2.31 ±0.91 postoperatively,and 2.26 ±0.88 at final follow-up. The results showed that 41 cases were Type Ⅰ on MRI,69 were Type Ⅱ and 27 were Type Ⅲ. Significant improvement was observed at the post-operative versus pre-operative assessments in Type Ⅰ and Type Ⅱ. No significant differences were observed between post-and pre-operative assessments in Type Ⅲ. [ Conclusion] The curative effect of percutaneous kyphoplasty for the treatment of acute VCFs appears superior to that of chronic VCFs. After a definite diagnosis of VCFs, percutaneous kyphoplasty should be performed as early as possible in order to obtain a better therapeutic effect.
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2009年第18期1361-1364,共4页
Orthopedic Journal of China
