【作者】 付奎；

【导师】 王鸿飞；

【作者基本信息】 大连医科大学 ， 外科学， 2009， 硕士

【摘要】 目的:回顾并总结球囊扩张椎体后凸成形术治疗新鲜骨质疏松性椎体压缩骨折的临床疗效,手术适应症、并发症及相关操作要点。方法:回顾性分析大连医科大学附属第二医院2007～2009年间,应用球囊扩张椎体后凸成形术治疗新鲜骨质疏松性胸腰椎压缩性骨折并获得随访3个月以上的20例患者的临床资料,其中男性5例,女性15例。年龄50～80岁,平均64岁。病程1～15天。平均3天。本组均为单椎体骨折,部位T12椎体2例、L1椎体5例、L2椎体4例、L3椎体3例、L4椎体4例、L5椎体2例。手术方式:经皮球囊扩张椎体后凸成形术,采用经双侧椎弓根途径球囊扩张成形系统。采用疼痛强度评价的视觉类比评(Visual Analogue Scale,VAS)VAS评分及手术前后病椎形态变化对比,对术后疗效及相关因素进行讨论分析。结果:1.平均随访时间13个月(3～24个月)。采用电话或门诊随访。2.VAS评分:术前7～9分,平均8.33分,术后0～4分,平均为2.45分,手术前后有显著差异(P<0.01)。3.病椎形态变化情况:椎体前缘高度术前为0.8～2.4cm,平均为1.85cm,术后为1.4～3.0cm,平均为2.43cm,手术前后差异有显著性(P<0.01)。椎体中间高度术前为1.3～2.5cm,平均为2.03cm,术后为1.7～2.8cm,平均为2.54cm,手术前后差异有显著性(P<0.01)。椎体后缘高度术前为2.5～3.4cm,平均为2.95cm,术后为2.5～3.5cm,平均为3.01cm,手术前后差异无显著(P>0.05)。结论:球囊扩张椎体后凸成形术治疗新鲜骨质疏松性椎体压缩骨折止痛效果确切,椎体高度能不同程度得到恢复,操作简便。更多还原

【Abstract】 Objective:To look back and sum up the expansion balloon kyphoplasty treatment of fresh osteoporotic vertebral compression fractures in clinical efficacy, surgical indications, complications and related operating elements. Methods:Retrospective analysis of Second Affiliated Hospital of Dalian Medical University between 2007-2009,the application of balloon kyphoplasty to expand the treatment of fresh osteoporotic thoracolumbar vertebral compression fractures and more than 3 months follow-up of 20 cases of patients with clinical data,including five cases of male,female 15 cases.Age 50-80 years old,an average of 64 years.Course of 1-15 days.An average of 3 days.In this group are single vertebral fracture,2 cases of parts of T12 vertebral body,L1 vertebral body in 5 cases,L2 vertebral body in 4 cases,L3 vertebral body in 3 cases,L4 vertebral body in 4 cases,L5 vertebral body in 2 cases.Surgical approach:the expansion of percutaneous balloon kyphoplasty using bilateral pedicle by means of balloon mitral system. Evaluation of pain intensity using visual analogue assessment (Visual Analogue Scale,VAS) VAS score and surgical disease of vertebral morphological changes before and after comparison of the efficacy and after discussion and analysis of relevant factors.Results:1. The average follow-up period was 13 months(3-24 months).Using the telephone or out-patient follow-up.2. VAS score:7-9 hours preoperatively,with an average 8.33 points,after 0 to 4 points,an average of 2.45 points,before and after surgery were significantly different(P <0.01). 3. Morphological changes in vertebral disease:preoperative vertebral body height front for 0.8-2.4 cm,an average of 1.85 cm,after for 1.4-3.0cm, an average of 2.43 cm,before and after surgery there was a significant difference(P <0.01).Preoperative vertebral body height to the middle of 1.3-2.5cm,an average of 2.03cm,after for the 1.7-2.8cm,an average of 2.54 cm,before and after surgery there was a significant difference(P <0.01). Margin of vertebral body height after the surgery before the 2.5-3.4 cm,an average of 2.95 cm,after for the 2.5-3.5cm,an average of 3.01cm,before and after surgery there was no significant difference(P> 0.05).Conclusion:Balloon Kyphoplasty to expand the treatment of new osteoporotic vertebral compression fractures precise analgesic effect, vertebral height can be restored to varying degrees,easy to operate.更多还原