| 两种途径的椎体后凸成形术治疗老年脆性椎体骨折中远期疗效分析 |
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投稿时间：2017-01-11
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| 作者 | Author | 单位 | Address | E-Mail |
| 俞华军 |
YU Hua-jun |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
ZHANG Xiao-wen, and ZHANG Chun. Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 马苟平 |
MA Gou-ping |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
ZHANG Xiao-wen, and ZHANG Chun. Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 郭峭峰 |
GUO Qiao-feng |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
ZHANG Xiao-wen, and ZHANG Chun. Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 张晓文 |
ZHANG Xiao-wen |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
ZHANG Xiao-wen, and ZHANG Chun. Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
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| 张春 |
ZHANG Chun |
浙江省立同德医院骨伤科, 浙江 杭州 310012 |
ZHANG Xiao-wen, and ZHANG Chun. Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou 310012, Zhejiang, China |
42485782@qq.com |
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| 期刊信息：《中国骨伤》2017年，第30卷，第5期，第426-430页 |
| DOI：10.3969/j.issn.1003-0034.2017.05.005 |
| 基金项目:浙江省医药卫生科技计划项目（编号：2015KYB078） |
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中文摘要:
目的：评估单侧与双侧椎体后凸成形术治疗老年脆性椎体骨折患者中远期的临床疗效。
方法：回顾性分析2008年1月至2010年1月单双侧椎体后凸成形术治疗老年脆性椎体骨折的临床资料，按统一的纳入、排除标准纳入临床研究的患者104例，男44例，女60例，按术中途径分为单侧组（手术运用单侧椎弓根途径行PKP治疗的患者）和双侧组（手术运用双侧椎弓根途径行PKP治疗的患者），分别于术前及术后3 d、3个月、1年、3年、末次随访进行VAS评分、Cobb角改善、椎体前后缘高度变化等指标对比，评估两组的疗效和安全性。
结果：所有患者手术顺利，单侧组手术时间、骨水泥注入量较双侧组少（P<0.05）；两组术后VAS评分均较术前明显降低（P<0.05），椎体前后缘高度及局部Cobb角较术前均有显着恢复（P<0.05），而术后各时间点两组间VAS评分、Cobb角改善、椎体前后缘高度比较差异均无统计学意义（P>0.05）.并发症方面：骨水泥渗漏12例（11.5%），椎体再次骨折5例（4.8%），脑脊液漏2例（1.9%），神经根刺激症状3例（2.9%），均为一过性，对症治疗后缓解。
结论：单侧与双侧椎体后凸成形术治疗老年脆性椎体骨折中长期疗效均安全、满意，可作为一种微创治疗手段推广，而单侧椎弓根途径椎体后凸成形术手术时间较短、创伤相对较少，是更理想的方式。 |
| 【关键词】后凸成形术 骨质疏松 骨折 老年人 |
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| Mid and long-term clinical effects of percutaneous kyphoplasty with two methods for vertebral fragility fracture in the elderly |
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ABSTRACT
Objective: To evaluate the middle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty(PKP) for vertebral fragility fracture in the elderly.
Methods: The clinical data in elderly patients with vertebral fragility fracture treated by unilateral and bilateral PKP between January 2008 and January 2010 was retrospective analyzed. According to a unified criteria to divided into two groups for 104 patients(44 males and 60 females),of them,50 cases were divided in unilateral group using unilateral pedicle surgical approach for PKP and 54 cases were in bilateral group using bilateral pedicle approach. VAS score,Cobb angle,and the height of anterior and posterior vertebral body were respectively analyzed peroperatively and at 3 d,3 months,1 year,3 years postoperatively and final follow-up. Clinical effects and safety were assessed in two groups.
Results: All the operations were successful. Operative time and bone cement injection volume in unilateral group were less than those of bilateral group(P<0.05). Postoperative VAS scores,Cobb angle,and the height of anterior and posterior vertebral body were obviously improved in two groups(P<0.05),and there was no significant difference between two groups(P>0.05). Bone cement leakage occurred in 12 cases(11.5%),recurrent fracture of vertebral body occurred in 5 cases(4.8%),cerebrospinal leak occurred in 2 cases(1.9%),and nerve root irritation occurred in 3 cases(2.9%). The above complications were transient and released after symptomatic treament.
Conclusion: Middle-long-term clinical effects of unilateral and bilateral percutaneous kyphoplasty for vertebral fragility fracture are safe and satisfactory,and may be extended as a minimally invasive method. Unilateral approach for PKP has advantages of short operation time,relative less trauma,thus is a more ideal method. |
| KEY WORDS Kyphoplasty Osteoporosis Fractures Aged |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 俞华军,马苟平,郭峭峰,张晓文,张春.两种途径的椎体后凸成形术治疗老年脆性椎体骨折中远期疗效分析[J].中国骨伤,2017,30(5):426~430 |
| 英文格式: | YU Hua-jun,MA Gou-ping,GUO Qiao-feng,ZHANG Xiao-wen,ZHANG Chun.Mid and long-term clinical effects of percutaneous kyphoplasty with two methods for vertebral fragility fracture in the elderly[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(5):426~430 |
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