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[1]陳雯,馬俊明,莫文.骨水泥聯(lián)合Genex人工骨經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性胸腰椎壓縮性骨折[J].中醫(yī)正骨,2018,30(06):40-43.
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骨水泥聯(lián)合Genex人工骨經(jīng)皮椎體后凸成形術(shù)治療骨質(zhì)疏松性 胸腰椎壓縮性骨折()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第30卷
期數(shù):
2018年06期
頁(yè)碼:
40-43
欄目:
臨床報(bào)道
出版日期:
2018-06-20

文章信息/Info

作者:
陳雯馬俊明莫文
上海中醫(yī)藥大學(xué)附屬龍華醫(yī)院,上海 200032
關(guān)鍵詞:
脊柱骨折 骨質(zhì)疏松性骨折 胸椎 腰椎 椎體后凸成形術(shù) 骨水泥 Genex人工骨
文獻(xiàn)標(biāo)志碼:
A
摘要:
目的:探討骨水泥聯(lián)合Genex人工骨經(jīng)皮椎體后凸成形術(shù)(percutaneous kyphoplasty,PKP)治療骨質(zhì)疏松性胸腰椎壓縮性骨折的臨床療效及安全性。方法:2014年8月至2016年9月,采用骨水泥聯(lián)合Genex人工骨PKP治療骨質(zhì)疏松性胸腰椎壓縮性骨折患者91例,男20例、女71例; 年齡60~92歲,中位數(shù)70歲。單節(jié)段骨折85例,其中T92例、T105例、T1110例、T1219例、L124例、L213例、L38例、L44例; 雙節(jié)段骨折6例,其中T11~T122例,T12~L14例。受傷至手術(shù)時(shí)間12 h至30 d,中位數(shù)15 d。分別在術(shù)前和術(shù)后7 d、1個(gè)月、3個(gè)月、6個(gè)月時(shí),在X線(xiàn)片上測(cè)量傷椎高度及傷椎后凸Cobb角,計(jì)算傷椎相對(duì)高度比,分別采用疼痛視覺(jué)模擬量表(visual analogue scale,VAS)評(píng)分、Oswestry功能障礙指數(shù)(Oswestry disability index,ODI)和簡(jiǎn)明健康狀況調(diào)查表(short form 36 health survey questionnaire,SF-36)評(píng)估患者腰背部疼痛、脊柱功能和生活質(zhì)量。隨訪(fǎng)觀(guān)察并發(fā)癥發(fā)生情況。結(jié)果:本組91例均順利完成手術(shù),手術(shù)時(shí)間11~34 min,中位數(shù)23 min。91例患者均獲6個(gè)月隨訪(fǎng)。傷椎高度,術(shù)前(16.21±2.08)mm、術(shù)后7 d(22.05±2.41)mm、術(shù)后1個(gè)月(21.68±1.89)mm、術(shù)后3個(gè)月(20.98±1.88)mm、術(shù)后6個(gè)月(19.98±1.69)mm; 傷椎相對(duì)高度比,術(shù)前0.54±0.11、術(shù)后7 d 0.86±0.09、術(shù)后1個(gè)月0.85±0.17、術(shù)后3個(gè)月0.79±0.21、術(shù)后6個(gè)月0.84±0.13; 傷椎后凸Cobb角,術(shù)前19.18°±3.65°、術(shù)后7 d 7.83°±1.31°、術(shù)后1個(gè)月8.32°±1.71°、術(shù)后3個(gè)月8.75°±1.81°、術(shù)后6個(gè)月9.17°±1.93°。腰背部疼痛VAS評(píng)分,術(shù)前(8.27±1.18)分、術(shù)后7 d(3.78±0.81)分、術(shù)后1個(gè)月(3.18±0.73)分、術(shù)后3個(gè)月(3.09±0.63)分、術(shù)后6個(gè)月(2.65±0.37)分; ODI,術(shù)前(41.30±5.10)%、術(shù)后7 d(24.39±4.62)%、術(shù)后1個(gè)月(22.30±4.50)%、術(shù)后3個(gè)月(22.45±4.17)%、術(shù)后6個(gè)月(22.24±4.34)%; SF-36評(píng)分,術(shù)前(91.58±21.62)分、術(shù)后7 d(115.53±27.12)分、術(shù)后1個(gè)月(110.17±21.61)分、術(shù)后3個(gè)月(112.90±23.96)分、術(shù)后6個(gè)月(111.78±24.53)分。均無(wú)骨水泥滲漏、脊髓和神經(jīng)根損傷、肺栓塞等并發(fā)癥發(fā)生。結(jié)論:骨水泥聯(lián)合Genex人工骨PKP治療骨質(zhì)疏松性胸腰椎壓縮性骨折,可恢復(fù)傷椎高度、矯正脊柱畸形、緩解腰背部疼痛、改善脊柱功能、提高患者生活質(zhì)量,且并發(fā)癥少。

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更新日期/Last Update: 2018-10-30