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计算机断层扫描引导下的骶骨成形术:一种治疗骶骨不全骨折的实用方法:病例报告

Computerized tomography guided sacroplasty: a practical treatment for sacral insufficiency fracture: case report.

作者信息

Brook Allan L, Mirsky David M, Bello Jacqueline A

机构信息

Department of Radiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

出版信息

Spine (Phila Pa 1976). 2005 Aug 1;30(15):E450-4. doi: 10.1097/01.brs.0000172182.35619.d1.

Abstract

STUDY DESIGN

Small case series projecting widespread therapeutic implications.

OBJECTIVE

To promote sacroplasty as a feasible treatment for sacral insufficiency fractures.

SUMMARY OF BACKGROUND DATA

Osteoporosis, a major cause of vertebral and sacral insufficiency fractures, is an increasingly serious problem in the elderly population. Painful sacral fractures often cause patients to be immobile, and at increased risk for comorbidities and osteoporosis progression. Currently, there is no therapy available for the treatment of these fractures. Vertebroplasty has evolved as a standard of care for treating fractures as a result of malignant and nonmalignant spinal pathology. Sacroplasty represents a reasonable adaptation of this interventional technique.

METHODS

Computerized tomography (CT) guidance was used to monitor percutaneous polymethylmethacrylate injection into sacral insufficiency fractures.

RESULTS

We report 2 cases of elderly patients with posttraumatic sacral insufficiency fractures, whose symptoms were completely relieved following CT-guided internal fixation by percutaneous polymethylmethacrylate injection.

CONCLUSION

Under CT guidance, sacroplasty is a safe, practical, and effective solution to this underdiagnosed problem, with potential for comorbidities resulting in prolonged, costly hospital admissions for the elderly.

摘要

研究设计

具有广泛治疗意义的小病例系列。

目的

推广骶骨成形术作为治疗骶骨不全骨折的一种可行治疗方法。

背景资料总结

骨质疏松症是椎体和骶骨不全骨折的主要原因,在老年人群中是一个日益严重的问题。疼痛性骶骨骨折常导致患者活动受限,且合并症及骨质疏松进展风险增加。目前,尚无治疗这些骨折的有效方法。椎体成形术已发展成为治疗恶性和非恶性脊柱病变所致骨折的一种标准治疗方法。骶骨成形术是这种介入技术的合理应用。

方法

采用计算机断层扫描(CT)引导监测经皮向骶骨不全骨折内注射聚甲基丙烯酸甲酯。

结果

我们报告2例老年创伤后骶骨不全骨折患者,经CT引导下经皮聚甲基丙烯酸甲酯注射内固定后症状完全缓解。

结论

在CT引导下,骶骨成形术是解决这一诊断不足问题的一种安全、实用且有效的方法,对于可能因合并症导致老年患者住院时间延长、费用增加的情况具有潜在价值。

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