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华西医学  2015 

经皮椎体成形术后非手术椎体新发骨折的临床分析

DOI: 10.7507/1002-0179.20150351, PP. 1217-1221

Keywords: 都江堰市医疗中心骨科(四川都江堰611830)

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Abstract:

目的?分析骨质疏松椎体压缩性骨折行椎体成形术后非手术椎体骨折再次行椎体成形术的疗效及临床特点。方法?2008年1月-2013年5月,因骨质疏松椎体压缩性骨折接受椎体成形术的患者共277例(331椎)。术后新发骨折需要手术治疗者42例。将其分为邻近椎体新发骨折组(A组)19例,非邻近椎体新发骨折组(B组)23例。比较首次及再次椎体成形术后患者疼痛强度及功能改善,比较A组与B组一般资料、新发骨折的时间、骨水泥注入量、骨水泥渗漏情况及手术相关并发症。结果?首次与再次椎体成形术后1d疼痛视觉模拟评分改善率分别为(64.6±12.6)%及(67.4±12.8)%,差异无统计学意义(P>0.05);改良Oswestry失能指数评分改善率分别为(60.6±13.3)%及(62.6±12.9)%,差异无统计学意义(P>0.05)。首次行椎体成形术与新发椎体压缩骨折的时间间隔A组(62.4±45.5)d,B组(203.7±77.6)d,差异有统计学意义(P<0.05)。A组与B组在一般资料、骨水泥注入量及渗漏情况等方面差异均无统计学意义(P>0.05)。5例患者再次椎体成形术后发生脊柱旁骨水泥渗漏,其中1例在术后3个月发现邻近椎体压缩骨折。所有患者再次椎体成形术后均未发生手术相关并发症。结论?再次椎体成形术治疗新发椎体压缩骨折对患者疼痛及功能改善与首次手术疗效相当;邻近椎体新发骨折多在首次椎体成形术后早期发生。

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