胸腰椎骨质疏松性骨折骨不连骨水泥破壁填充治疗△

Transwall bone cement filling for thoracolumbar osteoporotic fracture complicated with nonunion

摘要:

[目的]评估骨水泥破壁填充法治疗老年性胸腰椎骨质疏松性骨折伴骨不连的临床疗效。[方法]回顾分析本科采用骨水泥破壁填充法治疗老年性胸腰椎骨质疏松骨质伴骨不连 34 例患者的临床资料，分别在术前、术后第 3 d 及末次随访时， 记录 VAS 及 ODI 评分、测量局部后凸畸形情况、评估并发症。[结果] 34 例患者均成功接受手术，其中 4 例患者椎间隙存在无症状性骨水泥渗漏。与术前相比，术后第 3 d 和末次随访时患者的 VAS [(8.1±0.9), (1.9±0.6), (1.4±0.7), P＜0.001] 和 ODI 评分 [(78.8±7.9), (33.7±3.4), (32.1±3.3), P＜0.001] 显著降低。影像方面，与术前相比，术后第 3 d 局部后凸角 [(13.1±2.8)°, (4.9±2.4)°, (5.1±2.5)°, P＜0.001] 和椎体前缘高度 [(16.2±1.6) mm, (19.1±1.2) mm, (19.1±1.2) mm, P＜0.001] 均显著改善。[结论] 骨水泥破壁填充法治疗老年性胸腰椎骨质疏松骨折伴骨不连是一种安全技术，临床疗效满意。

Abstract:

[Objective] To evaluate the clinical outcome of trans-wall bone cement filling for thoracolumbar osteoporotic fracture complicated with nonunion in the elderly. [Methods] A total of 34 patients received trans-wall bone cement filling for thoracolumbar osteoporotic fracture complicated with nonunion in our department. The VAS and ODI scores were recorded, and local kyphotic angle and anterior vertebral body height (AVBH) was measured and complications were evaluated before surgery, 3 days after surgery and at the last followup. [Results] All 34 patients underwent operation successfully, and 4 of them had asymptomatic bone cement leakage in the intervertebral space. With time before surgery, 3 days postoperatively, and the latest follow-up, the VAS [(8.1±0.9), (1.9±0.6), (1.4±0.7), P＜0.001] and ODI scores [(78.8±7.9), (33.7±3.4), (32.1±3.3), P＜0.001] significantly reduced. As for imaging, the LKA [(13.1±2.8)°, (4.9±2.4)°, (5.1± 2.5)°, P＜0.001] and AVBH [(16.2±1.6) mm, (19.1±1.2) mm, (19.1±1.2) mm, P＜0.001] were significantly improved. [Conclusion] The trans-wall bone cement filling is a safe technique for thoracolumbar osteoporotic fracture with bone nonunion in elderly, and achieves satisfactory.