| 摘要: |
| 目的探讨经皮椎体成形术（PVP）治疗腰椎融合术后邻椎骨折的临床疗效。方法回顾性分析2010年1月至2013年12月行PVP的病例资料，其中腰椎融合术后邻椎骨折12例，同时随机选择15例无腰椎融合术病史、性别匹配且骨质疏松性椎体骨折患者作为对照组，分析两组患者临床特征，并采用视觉模拟评分法（VAS）和Oswestry功能障碍指数（ODI）评估临床疗效。结果腰椎融合术后邻椎骨折患者均为女性，平均年龄（64.0±6.4）岁；骨折均发生在融合节段的近侧椎体，依据AO分型均为A1型骨折，平均BMD（-2.1±0.5）T。腰椎融合术后邻椎骨折患者VAS由术前（8.2±1.1）分降至术后1个月（3.0±0.7）分、术后6个月（2.3±0.5）分，3个时间点比较差异有统计学意义（P＜0.01）；ODI由术前（84.6±6.8）%降至术后1个月（30.6±5.4）%、术后6个月（26.0±4.8）%，3个时间点比较差异亦有统计学意义（P＜0.01）。腰椎融合术后邻椎骨折患者各个时间点VAS、ODI与对照组比较，差异均无统计学意义（均P＞0.05）。融合术后邻椎骨折患者BMD明显高于对照组（P＜0.05）。术中未发生明显的骨水泥渗漏、神经损伤等并发症；术后随访期间未出现伤椎再骨折或其他椎体骨折。结论PVP治疗腰椎融合术后邻椎骨折与骨质疏松性椎体骨折的临床疗效接近，是一种安全、有效的方法。 |
| 关键词: 经皮椎体成形术 骨质疏松性骨折 腰椎融合术 |
| DOI： |
| 分类号: |
| 基金项目:浙江省自然基金资助项目 |
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| Clinical efficacy of percutaneous vertebroplasty for adjacent vertebral fractures after lumbar interbody fusion |
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WANG Jian, LIU Jian, XU Weixing
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Tongde Hospital of Zhejiang province
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| Abstract: |
| Objective To evaluate the clinical efficacy of percutaneous vertebroplasty (PVP) for treatment of adjacent vertebral fractures after lumbar interbody fusion. Methods Twelve patients with vertebral compressive fracture adjacent to lumbar fusion segment underwent PVP surgery from January 2010 to December 2013,and 15 gender-matched patients with osteoporotic fractures and no history of lumbar fusion treated by PVP were randomly selected as the control group. The age, gender, body mass index (BMI) and bone mineral density (BMD) were documented and clinical efficacy was assessed by Analogue Scale Visual (VAS) and Oswestry Disability Index (ODI). Results All patients were female with an average age of (64.0±6.4) years. The type of fracture was A1 according to the AO classification, the average BMD value was (-2.1 ±0.5)T. The VAS scores were reduced from(8.2±1.1) before operation to (3.0±0.7) 1 month after operation, and(2.3±0.5) 6 months after operation (P＜0.01). ODI scores were reduced from(84.6±6.8)% before operation to(30.6±5.4)% and(26.0±4.8)% 1 and 6 month after operation, respectively (P＜0.01). There were no significant differences in VAS and ODI scores in all time points between PVP group and control group (P ＞0.05). However, the BMD of PVP group was significantly higher than that of control group (P ＜0.05). There was no cement leakage, nerve injury during surgery and no new vertebral fractures after operation. Conclusion The adjacent vertebral fractures after lumbar interbody fusion often occur in elderly female patients, PVP can be used as an effective method for the treatment of this type of fracture. |
| Key words: Percutaneous vertebroplasty Osteoporotic compressive fracture Lumbar interbody fusion |
