后凸成形术对老年多椎体骨质疏松压缩骨折的选择治疗21例观察【临床医学毕业论文设计，精.doc

《后凸成形术对老年多椎体骨质疏松压缩骨折的选择治疗21例观察【临床医学毕业论文设计，精.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、临床医学论文•后凸成形术对老年多椎体骨质疏松压缩骨折的选择治疗21例观察作者：王木木‘陶惠人‘罗卓荆‘李新奎‘马真胜‘李明全‘杨旻【摘要】〔冃的〕探讨依据术前MRI检查结果对老年多椎体骨质疏松压缩骨折行选择性椎体后凸成形术的疗效。〔方法〕自2003年6月〜2006年12月老年多椎体骨质疏松压缩骨折21例57椎，采用根据术前MRI信号改变判断疼痛性椎体和陈旧骨折椎体，行选择性球囊扩张后凸成形术的治疗方法。对疼痛性椎体采用正常球囊扩张压力和足量骨水泥充塡；对陈旧T生骨折椎体采用较低球囊扩张压力和少量骨水泥充塡，不

2、追求恢复椎体高度。观察术后症状改善、骨折复位情况及有无并发症发生。〔结果〕21例手术均顺利完成，术后24h内疼痛均明显缓解。椎体前缘、中部、后缘平均高度术前分别为(1・7±0・9)cm，(1•7±0・7)cm，(2.5±0・9)cm，术后分别为(2.2±0.4)cm，(2.4±0・6)cm，(2.6±0.3)cm，椎体前缘、中部平均高度手术前后差异有统计学意义(PV0.01)。Cobb's角由术前33.7°±10.9°矫正至术后25.9°±9.3°，手术前后差异有统计学意义(P<0.01)。术后平均随访26・

3、3个月，患者疼痛症状均较术前明显改善或消失，未出现严重并发症。〔结论〕依据术前MRI结果对多椎体压缩骨折采用选择性后凸成形术治疗，临床效果满意，能够缩短手术时间、减少手术并发症、减少射线损害和手术费用，更适于老年多椎体骨质疏松压缩骨折的治疗。【关键词】骨质疏松；脊柱；骨折；后凸成形术Abstract:〔Objcctivc〕Toevaluatetheeffectofselectivckyphoplastyintreatmentofosteoporoticthoracolumbarmulti-vertebralc

4、ompressivefracturesbasedonpreoperativemagneticresonanceimaging(MRI).CMethodjTwenty-oneeases(fifty-sevenvertebralbodies)ofosteoporoticthoracolumbarmulIi-vertebralcompressivefracturesweretreatedfromJune2003toDecember2006・Thesignalchangesindifferentsequenceswe

5、reconfirmedbypreoperativeMRI.BasedontheMRIsignalchanges,57vertebralbodiesweretreatedbyselectivekyphoplasty.Normalballoonpressureandcementvolumewereperformedforthepainfulvertebralbodiesand1owerpressureandcementvolumewerepreferredforthevertebralbodieswitholdf

6、racture・〔Result〕Al1patientstoleratedtheoperationwe11withimmediatereliefoftheirbackpainin24hours.Themeanheightoftheanterior,mediaandposteriorvertebralbodieswere(l・7±0・9)cm,(1.7±0.7)cm,(2.5±0.9)cmpreoperativelyand(2.2±0.4)cm,(2.4±0.6)cm,(2.6±0.3)cmposloperali

7、vely.Themeankyphosiswasimprovedfrom(33.7±10.9)degreesto(25.9±9.3)degrees(P<0.01).Nocomplicationoccurred.Therewasnotbackpainanddeformed.Correctionwasmaintainedwe11after26.3monthsfollowup.〔Conclusion〕Theselectivetranspedicularballoonkyphoplastyforthoracolumba

8、rosteoporoticmulti・vcrtcbralfractureshassatisfactoryshorermclinicalefficacy.11isalsoaneffectivewaytoreduceoperationtime,radiationdose,andcostofoperation.Keywords:osteoporosis；spine；fracture；kyphoplasty