胸腰椎压缩性骨折的研究进展
Research Progress of Thoracolumbar Compression Fractures

随着人口老龄化，骨质疏松性椎体压缩性骨折(OVCF)的发生率正在逐渐增加。尤其位于胸腰交界区的椎体，作为胸腰椎的连接点，躯体的负重应力集中于此，而且由于其活动度较大及其特殊的解剖结构从而使其间的椎体容易发生骨折。OVCF也正在成为一个日益严重的公共卫生问题，具有重大的社会经济影响。根据美国国家骨质疏松症基金会(美国)的数据，美国约有1000万人患有骨质疏松症，每年约有75万例OVCF，中国的骨质疏松症发病率与西方国家没有太大区别。急性和慢性疼痛以及进行性脊柱畸形的患者人数也在逐渐增加。目前有几种不同的治疗策略：保守治疗、传统手术和微创手术。治疗的选择取决于骨折的类型和治疗的目的。虽然2/3的患者会通过保守治疗逐渐好转，1/3的骨折患者会出现慢性疼痛。此外，椎体压缩性骨折还可能导致身高下降、脊柱后凸、肺功能下降、活动能力和平衡受损。在胸腰椎压缩性骨折的患者中，由于骨折的椎体仍然处于持续的压迫状态，导致周围的神经持续刺激，并导致长期疼痛。因此，对于胸腰椎压缩性骨折的患者，医生应选择合理的治疗方法，以避免进一步压迫骨折的脊椎，还应解决疼痛，恢复椎体高度并改善脊柱后凸、纠正脊柱后凸，并避免神经损伤，这一点十分重要。
With the aging of the population, the incidence of osteoporotic vertebral compression fracture (OVCF) is gradually increasing. In particular, the vertebral bodies at the thoracolumbar junction, as the connection point between the thoracic and lumbar spine, bear the concentrated weight-bearing stress of the body. Moreover, due to their large range of motion and special anatomical structure, the vertebral bodies in this area are prone to fractures. OVCF is also becoming an increasingly serious public health problem with significant socioeconomic impacts. According to data from the National Osteoporosis Foundation (USA), approximately 10 million people in the United States suffer from osteoporosis, with about 750,000 cases of OVCF each year. The incidence of osteoporosis in China is not much different from that in Western countries. The number of patients with acute and chronic pain, as well as progressive spinal deformities, is also gradually increasing. Currently, there are several different treatment strategies: conservative treatment, traditional surgery, and minimally invasive surgery. The choice of treatment depends on the type of fracture and the treatment objective. Although two-thirds of patients will gradually improve through conservative treatment, one-third of fracture patients will experience chronic pain. In addition, vertebral compression fractures can also lead to a decrease in height, kyphosis, decline in lung function, and impairment of mobility and balance. In patients with thoracolumbar compression fractures, since the fractured vertebral body remains in a state of continuous compression, it causes continuous stimulation of the surrounding nerves and leads to long-term pain. Therefore, for patients with thoracolumbar compression fractures, it is very important that doctors should choose a reasonable treatment method to avoid further compression of the fractured vertebrae, relieve pain,