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治疗椎体压缩性骨折:确立适当的诊断、术前考虑因素、治疗技术、术后随访以及治疗有症状的椎体压缩性骨折患者的一般指南。

Treating Vertebral Compression Fractures: Establishing the Appropriate Diagnosis, Preoperative Considerations, Treatment Techniques, Postoperative Follow-Up and General Guidelines for the Treatment of Patients With Symptomatic Vertebral Compression Fractures.

机构信息

Clinical Radiology of Oklahoma, Edmond, OK.

Clinical Radiology of Oklahoma, Edmond, OK.

出版信息

Tech Vasc Interv Radiol. 2020 Dec;23(4):100701. doi: 10.1016/j.tvir.2020.100701. Epub 2020 Oct 5.

DOI:10.1016/j.tvir.2020.100701
PMID:33308580
Abstract

Vertebral compression fractures (VCFs) result from either trauma or a pathologic process that weakens the bone by conditions such as osteoporosis or tumor. The incidence of VCFs has been rising over the last few decades in accordance with the aging population. These fractures can result in severe pain, physical limitation and disability, as well as increased morbidity and mortality. Patients with VCFs are optimally treated by accurate and early diagnosis and treatment. An effective method to treat these fractures is percutaneous vertebral augmentation, which is a set of minimally invasive procedures that stabilizes osseous fractures, provides immediate pain relief, and improves quality of life. Vertebral augmentation procedures include vertebroplasty, kyphoplasty, and vertebral augmentation with implants. Each of these techniques is described in general terms in this article. The ideal candidate for vertebral augmentation is a patient with a symptomatic fracture seen on cross-sectional imaging in which nonsurgical management has failed and has positive signs on physical examination with no absolute contraindication. This procedure should be done with the appropriate equipment and personnel in a facility designed for this purpose. After the procedure, the patient should undergo the appropriate follow-up to ensure optimal recovery. Additionally, it is essential that the patient receives appropriate therapy for the underlying disorder that predisposed them to the vertebral fracture.

摘要

椎体压缩性骨折(VCF)可由创伤或使骨骼变脆弱的病理过程引起,如骨质疏松症或肿瘤。过去几十年中,随着人口老龄化,VCF 的发病率一直在上升。这些骨折可导致严重疼痛、身体受限和残疾,以及发病率和死亡率增加。通过准确和早期诊断及治疗,可优化 VCF 患者的治疗。治疗这些骨折的有效方法是经皮椎体强化术,这是一组微创程序,可稳定骨折,立即缓解疼痛,并提高生活质量。椎体强化术包括椎体成形术、后凸成形术和植入物椎体强化术。本文概括性地描述了这些技术。椎体强化术的理想人选是在横断面成像上出现症状性骨折的患者,经非手术治疗失败,体格检查有阳性体征,无绝对禁忌证。该程序应在为此目的设计的设施中使用适当的设备和人员进行。手术后,患者应进行适当的随访,以确保最佳恢复。此外,为易患椎体骨折的潜在疾病提供适当的治疗至关重要。

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