Gandy S, Payne R
Geriatrics. 1986 Dec;41(12):59-62, 67-74.
CT of compression fractures is a useful adjunct to the plain x-ray in excluding signs of metastasis. However, increased bone density on CT may not distinguish osteoporotic fractures from neoplastic disease, in which case radioiodine scan, bone and marrow biopsies, or myelography may be necessary. Surgery for painful osteoarthritic spinal disease is controversial. The potential advantages of surgery must be weighted against the risk of anesthesia, the length and tolerance of postoperative immobility, and the effect of laminectomy and fusion on the biomechanics of the spine. Furthermore, the elderly are at increased risk for postoperative complications.
压缩性骨折的CT检查是普通X线检查的有益辅助手段，可用于排除转移迹象。然而，CT上骨密度增加可能无法区分骨质疏松性骨折与肿瘤性疾病，在这种情况下，可能需要进行放射性碘扫描、骨与骨髓活检或脊髓造影。针对疼痛性骨关节炎性脊柱疾病的手术存在争议。手术的潜在益处必须与麻醉风险、术后制动的时长和耐受性，以及椎板切除术和融合术对脊柱生物力学的影响相权衡。此外，老年人术后并发症的风险更高。
