文档介绍：老年骨质疏松性椎体压缩骨折治疗临床体会
张雷钟喜红吴伟官容威程劲
【摘要】目的为有效地解决老年骨质疏松性椎体压缩骨折的脊柱稳定,探讨多节段椎弓根螺钉系统加后路脊柱融合术治疗老年骨质疏松性椎体压缩骨折的效果。方法本科自2004年3月—2010年1月采用多节段椎弓根固定辅助脊柱融合术治疗OVCF患者55例。结果分别于术后1周、1个月及末次随访VAS评分显著低于术前水平(P<)。%,%。止痛药物使用评分由术前肌注镇痛药物到末次随访少量口服或不吃药物,患者的生活水平得到明显的提高。所有患者末次随访X线及CT检查无断钉及松动,相邻椎体无再次骨折。结论多节段椎弓根螺钉系统加后路脊柱融合术治疗老年骨质疏松性椎体压缩骨折,可以使脊柱后路固定达到早期愈合的目的,也为脊柱的早期和后期稳定提供了很坚强的稳定。
【关键词】老年骨质疏松性椎体压缩骨折;多节段椎弓根固定;脊柱融合术
[Abstract]ObjectiveTo effectively solve the spine stabilization of osteoporotic pression fractures, observe the treatment effect of multi-segment pedicle screw system and posterior spinal fusion for osteoporotic pression In our department from March 2004 to Jan
uary 2010,a multi-segment pedicle fixation assisted spinal fusion surgery were done on 55 OVCF patients. Results After 1 week, 1 month and last follow-up VAS scores were significantly lower than preoperative levels respectively(P<). % of 36 cases from preoperative P5 to postoperative P1 in Denis classification, P2 approximately were % of 19 cases. Analgesic drug use score were from intramuscular injection of analgesic drugs before surgery to final follow up, or eat a small amount of oral medication, the patient's living standards have markedly improved. All patients were followed up for the last X ray and CT examination without broken nails and loose, without re-fracture of adjacent vertebrae. Conclusion Multi-segment pedicle screw system and treatment of posterior spinal fusion for osteoporotic pression fractures, posterior spinal fixation can achieve the purpose of early healing, but also for early and late stability of the spine provides a very strong stability.
[Key words] osteoporotic pression fractures; multi-segment pedicle fixation; spinal fusion
老年骨质疏松性椎体压缩骨折(OVCF)是指由于骨质疏松症造成骨组织内钙的逐渐丢失引起骨密度和骨强度的降低,造成椎体单发和多发压缩。随着社会的老龄化,骨质疏松症的患者逐年上升。由于认识上的问题,过去脊柱骨折常常因忽略而被漏诊,而实际上骨质疏松骨折中,脊柱骨折的犯病率较高。美国每年大约有1500000例骨质疏松骨折,其中脊柱骨折约700000例。老年骨质疏松性椎体压缩骨折患者主要症状