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| 骨质疏松性椎体骨折不愈合的临床特点与手术方法探讨 |
| The Clinical features and surgical operation approaches for the nonunion of osteoporotic vertebral compression fractures |
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| DOI： |
| 中文关键词: 骨质疏松性椎体骨折；不愈合 临床特点；手术 |
| 英文关键词:Osteoporosis vertebral fracture Nonunion Clinical features Surgical operation |
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| 中文摘要: |
| 目的探讨老年性骨质疏松性椎体骨折不愈合的临床特点与手术方法。方法对11例骨质疏松性椎体骨折不愈合患 者的临床表现与影像学特点进行归纳和分析.6例行经皮椎体成形或后凸成形术.5例行开放减压椎弓根系统复位固定直视下 椎体成形术。结果11例患者均顺利完成手术，椎体成形或后凸成形术后2?4天,手术后6?7天配带腰背支具下床活动.8 例患者椎体高度的恢复和Coob角改善.发生骨水泥漏1例，随访4?11个月，VAS评分由术前的7.5下降到术后3. 4.Oswestry 评分由术前的76下降到26.未见邻近节段发生再骨折.1例X线可见椎弓根螺钉道扩大。结论该类骨折不愈合有其特殊的 临床特点和影像学表现，手术方法应根据其临床特点进行选择。 |
| 英文摘要: |
| Objective To investigate the clinical features and surgical operation approaches for the nonunion of osteoporotic vertebral fractures in senile patients. Methods The clinical data of 11 patients with osteoporotic vertebral compression fracture nonunion. including clinical manifestations and imaging characteristics. were summarized and analyzed. Six patients were treated by vertebral angioplasty or kyphoplasty. and 5 patients received routine open decompression and reduction fixed vertebral angioplasty. Results All the 11 patients were successfully operated and got out of bed with cocoa belt waist after 24 days for patients with vertebroplasty or kyphoplasty. while after 6-7 days for those with routine operation. The vertebral height was restored in 8 patients with the improvement of Cobb angle. Bone cement leakage occurred in 1 patient. After 4-L1^nonth postoperative follow-up. VAS score decreased from preoperative 7. 5 to postoperative 3. 4. and Oswestry score from preoperative 76 to postoperative 26. No re-fracture of segmental or adjacent segment occurred. The pedicle screw nail was observed in the X-^ay image in 1 patient. Conclusion The results suggest that this kind of fracture nonunion has special clinical feature and imaging finding. Surgical operation approach should be selected based on the clinical feature. |
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