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椎体压缩性骨折的诊断与治疗。

Diagnosis and Management of Vertebral Compression Fracture.

机构信息

Department of Orthopedic Surgery, Alpert Medical School of Brown University, Providence, RI.

Alpert Medical School of Brown University, Providence, RI.

出版信息

Am J Med. 2022 Jul;135(7):815-821. doi: 10.1016/j.amjmed.2022.02.035. Epub 2022 Mar 18.

Abstract

Vertebral compression fractures are the most common complication of osteoporosis, with 700,000 cases reported every year in the United States. Vertebral compression fractures typically present with abrupt-onset low back pain with or without a history of trauma, although more than two-thirds are detected incidentally. Diagnosis is confirmed using plain radiographs, while computed tomography and magnetic resonance imaging may be required to evaluate for a malignant cause or if there are neurological deficits on examination. Magnetic resonance imaging is also the modality of choice to determine if the fracture is acute vs chronic in nature. Patients can be managed with a combination of nonsurgical modalities including medications, bracing, and physical therapy, although when indicated, kyphoplasty or vertebroplasty may be considered to provide symptom relief.

摘要

椎体压缩性骨折是骨质疏松症最常见的并发症,据报道,美国每年有 70 万例此类病例。椎体压缩性骨折通常表现为突发性腰痛,伴有或不伴有外伤史,尽管其中超过三分之二是偶然发现的。诊断采用 X 线平片确认,而计算机断层扫描和磁共振成像可能需要用于评估恶性病因或体格检查是否存在神经功能缺损。磁共振成像也是确定骨折性质为急性还是慢性的首选方式。患者可以采用包括药物、支具和物理治疗在内的非手术方法进行治疗,但是在有指征的情况下,可以考虑行后凸成形术或椎体成形术以缓解症状。

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