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因骨质疏松导致椎体塌陷后截瘫的后路脊柱缩短术

Posterior spinal shortening for paraparesis following vertebral collapse due to osteoporosis.

作者信息

Saita K, Hoshino Y, Higashi T, Yamamuro K

机构信息

Department of Orthopaedic Surgery, Jichi Medical School Omiya Medical Center, Saitama, Japan.

出版信息

Spinal Cord. 2008 Jan;46(1):16-20. doi: 10.1038/sj.sc.3102052. Epub 2007 Apr 3.

Abstract

STUDY DESIGN

Retrospective case series.

OBJECTIVES

To assess the efficacy of posterior spinal shortening for paraparetic patients following vertebral collapse owing to osteoporosis, especially on instrumentation loosening.

SETTING

Department of orthopaedic surgery, Jichi Medical University Hospital and Omiya Medical Center in Japan.

METHODS

The clinical records and radiographs of 13 patients with paraparesis following vertebral collapse owing to osteoporosis treated with posterior spinal shortening were retrospectively reviewed to evaluate the usefulness of this method. Assessment of the clinical course was done by direct examination in all cases. Ambulatory ability was divided into four categories.

RESULTS

Upon final observation, nine cases were able to walk with a cane or crutch, one case remained in gait training, two cases remained unable to stand and one case with urinary incontinence improved in urinary function. In one case, paralysis deteriorated. Vertebral compression fracture of the end vertebrae that were fixed occurred in three cases complicated with rheumatoid arthritis.

CONCLUSION

The posterior spinal shortening can be a choice for treating delayed paraparesis following vertebral collapse owing to osteoporosis.

摘要

研究设计

回顾性病例系列研究。

目的

评估后路脊柱缩短术治疗骨质疏松性椎体塌陷所致双下肢轻瘫患者的疗效,尤其是对器械松动的影响。

地点

日本自治医科大学医院和大宫医疗中心骨科。

方法

回顾性分析13例因骨质疏松性椎体塌陷导致双下肢轻瘫而行后路脊柱缩短术患者的临床记录和X线片,以评估该方法的有效性。所有病例均通过直接检查评估临床病程。行走能力分为四类。

结果

末次随访时,9例患者能够拄拐杖或使用助行器行走,1例仍在进行步态训练,2例仍无法站立,1例尿失禁患者的排尿功能有所改善。1例患者瘫痪加重。3例合并类风湿关节炎的患者,其固定节段的终末椎体发生了椎体压缩骨折。

结论

后路脊柱缩短术可作为治疗骨质疏松性椎体塌陷所致迟发性双下肢轻瘫的一种选择。

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