| 腰椎定量CT在合并脊柱侧弯的骨质疏松性骨折行椎体成形术的应用价值 |
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投稿时间：2020-11-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 邓闽军 |
DENG Min-jun |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
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| 孙振国 |
SUN Zhen-guo |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
77520057@qq.com |
| 翁伟 |
WENG Wei |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
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| 杨红航 |
YANG Hong-hang |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
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| 张占丰 |
ZHANG Zhan-feng |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
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| 闵继康 |
MIN Ji-kang |
湖州市第一人民医院骨科 浙北骨质疏松骨病防治中心 湖州师范学院附属第一医院, 浙江 湖州 313000 |
Department of Orthopaedics, the First People's Hospital of Huzhou, Osteoporotic Osteopathy Prevention and Treatment Center of Northern Zhejiang, the First Affiliated Hospital of Huzhou Normal University, Huzhou 313000, Zhejiang, China |
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| 期刊信息：《中国骨伤》2021年，第34卷，第11期，第1077-1082页 |
| DOI：10.12200/j.issn.1003-0034.2021.11.017 |
| 基金项目:浙江省基础公益研究计划（编号：LGF20H060009） |
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中文摘要:
目的：探讨腰椎定量CT （QCT）在合并脊柱侧弯的骨质疏松性骨折行椎体成形术中的应用价值。
方法：对2017年12月至2019年12月采用椎体成形术治疗的60例合并不同程度脊柱侧弯的骨质疏松性骨折患者进行回顾性研究分析。其中男18例，女42例；年龄65~81（72.63±3.34）岁。60例患者术前均进行腰椎QCT检测，根据QCT检测值分为3个等级：骨量减少组（QCT值>80 g/L，10例，12个椎体）；骨质疏松组（QCT值40~80 g/L，35例，48个椎体）；严重骨质疏松组（QCT值<40 g/L，15例，22个椎体）。观察不同程度QCT值患者的骨水泥在伤椎内的弥散及渗漏情况，并分析QCT值对脊柱侧弯患者行椎体成形术穿刺点选择、术后侧凸Cobb角矫正及椎体高度恢复的应用价值。
结果：60例82个椎体中，共有41例55个椎体采用凹侧单边穿刺，占67.07%。其中骨量减少组采用凹侧单边穿刺的有2例2个椎体，骨质疏松组采用凹侧单边穿刺的有26例35个椎体，严重骨质疏松组采用凹侧单边穿刺的有13例18个椎体；且3组患者间采用单侧或双侧穿刺的例数比较，差异有统计学意义（χ2=13.699，P=0.001）；3组间发生骨水泥渗漏的例数比较，差异无统计学意义（χ2=1.403，P=0.496）。术前与术后随访时脊柱侧凸Cobb角比较差异有统计学意义（P<0.05）；术前与术后随访时伤椎椎体高度比较差异有统计学意义（P<0.05）。
结论：对于合并脊柱侧弯的骨质疏松性骨折患者行椎体成形术时，根据腰椎QCT检测明确骨质疏松严重程度，选择脊柱侧弯的凹侧进行穿刺，有利于改善脊柱侧弯及恢复脊柱稳定性，提高手术安全性。 |
| 【关键词】骨质疏松性骨折 脊柱侧凸 腰椎定量CT 椎体成形术 |
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| Value of quantitative CT in vertebroplasty for osteoporotic fracture combined with scoliosis |
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ABSTRACT
Objective: To investigate the value of lumbar quantitative CT (QCT) in vertebroplasty for osteoporotic fracture combined with scoliosis.
Methods: The clinical data of 60 patients with osteoporotic fractures combined with different degrees of scoliosis treated by vertebroplasty from December 2017 to December 2019 were retrospectively analyzed. There were 18 males and 42 females, aged from 65 to 81(72.63±3.34)years old. All patients were received QCT examination before surgery. According to the QCT value, the patients were divided into osteopenia group(QCT>80 g/L, 10 cases, 12 vertebrae), osteoporosis group(QCT 40-80 g/L, 35 cases, 48 vertebrae) and severe osteoporosis group(QCT<40 g/L, 15 cases, 22 vertebrae). The dispersion and leakage of bone cement in the injured vertebrae of patients with different degrees of QCT value were observed, and the QCT value in the selection of puncture point, correction of Cobb angle and recovery of vertebral height were analyzed in the patients.
Results: Among 60 cases of 82 vertebrae, 41 cases of 55 vertebrae were punctured by concave unilateral puncture, according for 67.07%. Among them, there were 2 cases with 2 vertebrae in osteopenia group, 26 cases with 35 vertebrae in osteoporosis group, and 13 cases with 18 vertebrae in severe osteoporosis group. There was significant difference in the number of cases with unilateral or bilateral puncture among the three groups (χ2=13.699, P=0.001); there was no significant difference in the number of cases with bone cement leakage among the three groups (χ2=1.403, P=0.496). The Cobb angle of scoliosis was significantly different between preoperative and postoperative follow-up(P<0.05);the height of injured vertebral body was significantly different between preoperative and postoperative follow-up(P<0.05).
Conclusion: For patients with osteoporotic fracture combined with scoliosis undergoing vertebroplasty, the severity of osteoporosis should be determined according to lumbar QCT detection, and the concave side of scoliosis should be selected for puncture, which is conducive to improving scoliosis, restoring spinal stability and improving surgical safety. |
| KEY WORDS Osteoporotic fractures Scoliosis Lumbar quantitative CT Vertebroplasty |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 邓闽军,孙振国,翁伟,杨红航,张占丰,闵继康.腰椎定量CT在合并脊柱侧弯的骨质疏松性骨折行椎体成形术的应用价值[J].中国骨伤,2021,34(11):1077~1082 |
| 英文格式: | DENG Min-jun,SUN Zhen-guo,WENG Wei,YANG Hong-hang,ZHANG Zhan-feng,MIN Ji-kang.Value of quantitative CT in vertebroplasty for osteoporotic fracture combined with scoliosis[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(11):1077~1082 |
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