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目的探讨经皮椎体成形术治疗高龄骨质疏松性椎体压缩骨折的疗效。方法自2003年11月至2008年3月,对80岁以上高龄骨质疏松性椎体压缩骨折患者23例、26个椎体实行经皮椎体成形术。男8例,女15例;年龄80~92岁,平均84.2岁。术前对患者进行全面检查,一般状况平稳,无凝血及神经功能障碍、能耐受手术者行手术。术前CT检查明确病椎椎体后壁的完整性并用自行研制椎体定位器定位,术中应用C型臂X线机透视下经单侧椎弓根手术入路,平均骨水泥注射量2~5 mL左右。术前后应用疼痛视觉模拟评定法评分,并观察术中、术后并发症。术后X线CT检查了解骨水泥填充情况。结果所有患者术中手术顺利,术后1周疼痛明显减轻或消失。术前、术后1 h、48h、1周评分分别为(8.81±1.5)分、(4.04±1.21)分、(2.0±1.1)分、(1.6±0.9)分。术前、术后比较差异有显著性(P<0.05)。骨水泥填充满意。经过6~30个月(平均10个月)随访,1例发生其他椎体骨折再次行椎体成形术。患者主观满意程度,其中完全满意16例,满意6例,较满意1例。结论经皮椎体成形术是一种治疗高龄老年骨质疏松椎体骨折的微创手术,能有效缓解骨质疏松性椎体骨折引起的疼痛,维持椎体稳定性,提高老年患者的生活质量,是治疗骨质疏松性骨折的一种有效方法。
Objective To investigate the effect of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures in elderly patients. Methods From November 2003 to March 2008, 23 patients with osteoporotic vertebral compression fracture over 80 years old and 26 vertebral bodies underwent percutaneous vertebroplasty. 8 males and 15 females; aged 80 to 92 years old, with an average of 84.2 years old. Preoperative patients with a comprehensive examination of the general condition of a stable, non-coagulation and nerve dysfunction, can tolerate surgery for surgery. Preoperative CT examination confirmed the integrity of the posterior wall of the vertebral body vertebral body vertebral body positioning with its own positioning, intraoperative C-arm X-ray fluoroscopy through the unilateral pedicle approach, the average amount of bone cement injection 2 ~ 5 mL or so. Preoperative and postoperative pain visual analogue assessment score, and observed intraoperative and postoperative complications. Postoperative X-ray CT to understand the situation of bone cement filling. Results All patients underwent surgery successfully, and the pain was relieved or disappeared one week after operation. The preoperative, postoperative 1 h, 48 h, 1 week scores were (8.81 ± 1.5) points, (4.04 ± 1.21) points, (2.0 ± 1.1) points and (1.6 ± 0.9) points respectively. Preoperative and postoperative differences were significant (P <0.05). Satisfactory filling of bone cement. After 6 to 30 months (mean 10 months) follow-up, 1 case of other vertebral fractures again vertebroplasty. Subjective satisfaction of patients, of which 16 cases were completely satisfied, satisfied with 6 cases, more satisfied with 1 case. Conclusion Percutaneous vertebroplasty is a minimally invasive operation for the treatment of elderly osteoporotic vertebral fractures, which can effectively relieve the pain caused by osteoporotic vertebral fractures, maintain the stability of the vertebral body and improve the quality of life of elderly patients , Is an effective method for the treatment of osteoporotic fractures.