椎体支架系统经皮椎体后凸成形术结合唑来膦酸治疗重度骨质疏松性椎体骨折
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作者Author单位AddressE-Mail
徐响阳 XU Xiang-yang 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China  
罗德民 LUO De-min 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China  
刘尚礼 LIU Shang-li 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China bananasun001@126.com 
沈晓涛 SHEN Xiao-tao 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China  
周祖艳 ZHOU Zu-yan 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China  
元国栋 YUAN Guo-dong 东莞康华医院脊柱外科, 广东 东莞 523080 Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China  
期刊信息:《中国骨伤》2020年,第33卷,第9期,第827-830页
DOI:10.12200/j.issn.1003-0034.2020.09.007
基金项目:
中文摘要:目的:探讨椎体支架(vertebral body stents,VBS)系统经皮椎体后凸成形术(percutanous kyphoplasty,PKP)结合唑来膦酸治疗重度骨质疏松性椎体骨折的临床疗效。

方法:回顾性分析2017年12月至2018年12月收治的48例骨质疏松性胸腰椎骨折,其中男13例,女35例,年龄55~92(71.2±10.5)岁,全部采用VBS系统PKP手术方案,术后联合使用唑来膦酸注射液抗骨质疏松治疗,比较术前、术后3 d及半年的疼痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry Disability Index,ODI),病椎丢失高度,并观察术后有无病椎或邻椎再骨折情况。

结果:术前VAS评分为7.60±0.12,术后3 d为3.00±0.46,术后半年为1.20±0.23,术后VAS评分明显改善(P<0.05),术后3 d与术后半年比较差异无统计学意义(P>0.05)。术前ODI指数为(82.00±0.32)%,术后3 d为(30.00±1.50)%,术后半年为(18.00±0.16)%,术后ODI指数明显改善(P<0.05),术后3 d与术后半年比较差异无统计学意义(P>0.05)。术前病椎丢失高度为(12.00±0.43)mm,术后3 d为(3.00±0.15)mm,术后半年为(3.60±0.51)mm,术后病椎丢失高度明显减少(P<0.05),术后3 d与术后半年比较差异无统计学意义(P>0.05)。48例患者均获得随访,平均随访时间(6.6±0.5)个月,术后切口均甲级愈合,末次随访均未发生病椎及邻椎再骨折。

结论:VBS系统PKP结合唑来膦酸治疗骨质疏松性椎体骨折既可以有效缓解胸腰背部疼痛,改善胸腰椎活动度,又能最大程度地恢复椎体高度,预防病椎及邻椎再骨折,值得临床推广。
【关键词】椎体支架  经皮椎体后凸成形术  唑来膦酸  骨质疏松性椎体压缩骨折
 
Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid
ABSTRACT  Objective: To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs).

Methods: The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed,including 13 males and 35 females,aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery,and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI,the height of diseased vertebral lost were compared before operation,3 d and half a year after operation,and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed.

Results: Before operation,3 d and half a year after operation,VAS scores were 7.60±0.12,3.00±0.46,1.20±0.23,ODI were (82.00±0.32)%, (30.00±1.50)%, (18.00±0.16)%,the height of diseased vertebral lost were (12.00±0.43) mm, (3.00±0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score,ODI,the height of diseased vertebral lost were obviously improved (P<0.05),and there was no significant difference between 3 d and half a year after operation (P>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation,and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up.

Conclusion: VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back,improve the mobility of the thoracolumbar,but also can restore the height of the vertebral body to the maximum extent,and prevent the re-fracture of the affected vertebrae and adjacent vertebrae,which is worthy to spread in clinic.
KEY WORDS  Vertebral body stents  Percutanous kyphoplasty  Zoledronic acid  Osteoporotic vertebral compression fractures
 
引用本文,请按以下格式著录参考文献:
中文格式:徐响阳,罗德民,刘尚礼,沈晓涛,周祖艳,元国栋.椎体支架系统经皮椎体后凸成形术结合唑来膦酸治疗重度骨质疏松性椎体骨折[J].中国骨伤,2020,33(9):827~830
英文格式:XU Xiang-yang,LUO De-min,LIU Shang-li,SHEN Xiao-tao,ZHOU Zu-yan,YUAN Guo-dong.Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid[J].zhongguo gu shang / China J Orthop Trauma ,2020,33(9):827~830
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