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椎体支架系统联合经皮椎体后凸成形术及唑来膦酸治疗重度骨质疏松性椎体压缩骨折

[Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid].

作者信息

Xu Xiang-Yang, Luo De-Min, Liu Shang-Li, Shen Xiao-Tao, Zhou Zu-Yan, Yuan Guo-Dong

机构信息

Department of Spinal Surgery, Dongguan Kanghua Hospital, Dongguan 523080, Guangdong, China.

出版信息

Zhongguo Gu Shang. 2020 Sep 25;33(9):827-30. doi: 10.12200/j.issn.1003-0034.2020.09.007.

Abstract

OBJECTIVE

To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs).

METHODS

The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed, including 13 males and 35 females, aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery, and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI, the height of diseasedvertebral lost were compared before operation, 3 d and half a year after operation, and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed.

RESULTS

Before operation, 3 d and half a year after operation, VAS scores were 7.60±0.12, 3.00±0.46, 1.20±0.23, ODI were(82.00±0.32)%, (30.00±1.50) %, (18.00±0.16) %, the height of diseased vertebral lost were (12.00±0.43) mm, (3.00± 0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score, ODI, the height of diseased vertebral lost were obviously improved (<0.05), and there was no significant difference between 3 d and half a year after operation (>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation, and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up.

CONCLUSION

VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back, improve the mobility of the thoracolumbar, but also can restore the height of the vertebral body to the maximum extent, and prevent the re-fracture of the affected vertebrae and adjacent vertebrae, which is worthy to spread in clinic.

摘要

目的

探讨椎体支架(VBS)系统联合经皮椎体后凸成形术(PKP)及唑来膦酸治疗重度骨质疏松性压缩性椎体骨折(OVCFs)的临床疗效。

方法

回顾性分析2017年12月至2018年12月收治的48例骨质疏松性胸腰椎骨折患者的临床资料,其中男13例,女35例,年龄55~92岁,平均(71.2±10.5)岁。所有患者均采用VBS系统PKP手术治疗,术后采用唑来膦酸注射液进行抗骨质疏松治疗。比较术前、术后3 d及半年时的视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、病椎丢失高度,并观察术后病椎及相邻椎体有无再骨折。

结果

术前、术后3 d及半年时,VAS评分分别为7.60±0.12、3.00±0.46、1.20±0.23,ODI分别为(82.00±0.32)%、(30.00±1.50)%、(18.00±0.16)%,病椎丢失高度分别为(12.00±0.43)mm、(3.00±0.15)mm、(3.60±0.51)mm。术后VAS评分、ODI、病椎丢失高度均明显改善(P<0.05),术后3 d与半年时比较差异无统计学意义(P>0.05)。48例患者均获随访,平均随访时间(6.6±0.5)个月。术后所有切口均甲级愈合,末次随访时未见病椎及相邻椎体再骨折。

结论

VBS系统联合PKP及唑来膦酸治疗OVCFs不仅可有效缓解胸腰背部疼痛,改善胸腰段活动度,还能最大程度恢复椎体高度,预防病椎及相邻椎体再骨折,值得临床推广应用。

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