摘要
目的探讨应用Jack椎体扩张器系统行椎体后凸成形术选择性治疗中老年骨质疏松性Denis B型胸腰椎爆裂性骨折的可行性及近期疗效。方法 2007年8月-2011年5月,应用自行设计的Jack椎体扩张器系统行椎体后凸成形术治疗骨质疏松性Denis B型胸腰椎爆裂性骨折患者30例(32个椎体)。其中男7例,女23例;年龄57～85岁,平均76.9岁。骨折累及节段:T112个,T1211个,L17个,L25个,L33个,L44个。分别于术前、术后1周及6个月对患者行疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)评定,在X线片上测量椎体前缘高度、椎体中部高度及矢状面Cobb角。结果患者均顺利完成手术,无骨水泥渗漏及症状性并发症发生;术后腰背部疼痛均明显减轻。30例患者于术后1周和6个月获随访。术前、术后1周和术后6个月,VAS评分分别为(8.2±1.3)、(1.5±0.9)和(1.9±0.5)分,ODI分别为82.4%±15.0%、17.8%±9.5%和23.0%±8.6%,骨折椎体前缘高度分别为(19.5±3.2)、(24.8±3.0)和(24.0±2.6)mm,中部高度分别为(18.5±3.4)、(23.7±3.7)和(22.8±3.5)mm,Cobb角分别为(14.9±7.5)、(7.6±6.0)和(8.3±6.0)°。术后1周及6个月与术前比较差异均有统计学意义(P<0.05),术后1周和术后6个月比较差异均无统计学意义(P>0.05)。结论应用Jack椎体扩张器系统行椎体后凸成形术选择性治疗中老年骨质疏松性Denis B型胸腰椎爆裂性骨折,近期内可有效恢复骨折椎体前缘和中部高度,矫正畸形,缓解疼痛,改善功能,骨水泥渗漏发生率较低,具有良好的临床效果和安全性。
Objective To investigate the feasibility and effectiveness of selective treatment of senile osteoporotic thoracolumbar burst fractures of Denis type B with kyphoplasty and Jack vertebral dilator. Methods Between August 2007 and May 2011, 30 patients （32 vertebra） with osteoporotic thoracolumbar burst fractures of Denis type B were treated with kyphoplasty and Jack vertebral dilator. There were 7 males and 23 females, aged 57-85 years （mean, 76.9 years）. The injured vertebrae included Tu in 2 vertebrae, T12 in 11 vertebrae, L~ in 7 vertebrae, L2 in 5 vertebrae, L3 in 3 vertebrae, and L4 in 4 vertebrae. The visual analogue scale （VAS） score, Oswestry disability index （ODI）, the anterior and middle height of the vertebral body, and the Cobb angle were assessed before and after operation. Results The operation was completed smoothly in all cases; no cement leakage or intraoperative complication was found. Obvious back pain relief was achieved in all patients after operation. Thirty patients were followed up at 1 week and 6 months after operation. The VAS score was decreased from 8.2 ＋ 1.3 before operation to 1.5 ±0.9 at 1 week after operation and 1.9 ±0.5 at 6 months after operation; the ODI was decreased from 82.4%±15.0% to 17.8%±9.50/0 and 23.0%±8.6%; the anterior height of the vertebral body was increased from （19.5±3.2） mm to （24.8±3.0） mm and （24.0 ±2.6） mm; the middle height of the vertebral body was increased from （18.5±3.4） mm to （23.7±3.7） mm and （22.8±3.5） mm; the Cobb angle was decreased from （14.9±7.5）° to （7.6±6.0）° and （8.3±6.0）°; and there were significant differences in the VAS score, ODI, the anterior and middle height of the vertebral body, and the Cobb angle between at preand at post-operation （P 〈 0.05）, but no significant difference between at 1 week and at 6 months after operation （P 〉 0.05）. Conclusion Kyphoplasty with Jack vertebral dilator for selective treatment of senile osteoporotic thoracolumbar burstfractures of Denis type B can restore the anterior and middle height of the vertebral body, correct the Cobb angle, and relieve pain, and it has good short-term effectiveness and safety.
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2012年第8期972-976,共5页
Chinese Journal of Reparative and Reconstructive Surgery
基金
国家自然科学基金面上项目(30901528)
江苏省"科教兴卫工程"重点人才项目(RC2011054)~~
