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弥漫性特发性骨肥厚(DISH)相关椎体骨折的微创治疗方法:椎体骨水泥强化与骨水泥增强椎弓根螺钉内固定联合应用的病例报告

Minimally Invasive Approach for Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Related Vertebral Fractures: A Case Report on Combining Vertebral Cement Augmentation and Cement-Augmented Pedicle Screw Instrumentation.

作者信息

Inoue Takaki, Motegi Hiroyuki

机构信息

Department of Orthopaedic Surgery, Chiba Aoba Municipal Hospital, Chiba, JPN.

出版信息

Cureus. 2023 Nov 28;15(11):e49550. doi: 10.7759/cureus.49550. eCollection 2023 Nov.

Abstract

Diffuse idiopathic skeletal hyperostosis (DISH)-related vertebral fractures often require surgical intervention due to associated spinal instability and neurological deficits. This study presents a minimally invasive approach that utilizes vertebral cement augmentation and cement-augmented pedicle screw (PS) instrumentation to manage DISH-related vertebral fractures. We present an 87-year-old male patient with a T11 vertebral fracture associated with DISH. Despite the patient's advanced age and comorbidities, he underwent a successful surgical procedure, achieving relatively short-segment fixation by combining vertebral cement augmentation and cement-augmented PS instrumentation. After the surgery, the patient's lower back pain subsided, facilitating a return to normal activities. Radiographic evaluation at the six-month postoperative stage confirmed the maintenance of vertebral body reduction with no indications of implant failure. In DISH-associated vertebral fractures, the combined application of vertebral cement augmentation and cement-augmented PS instrumentation offers a minimally invasive solution that expedites fracture stabilization and enhances patient outcomes. This approach offers the potential for effective fracture stabilization and a significant reduction in postoperative complications, holding promise for managing challenging cases in this patient population.

摘要

弥漫性特发性骨肥厚(DISH)相关的椎体骨折常因伴有脊柱不稳定和神经功能缺损而需要手术干预。本研究提出了一种微创方法,该方法利用椎体骨水泥强化和骨水泥强化椎弓根螺钉(PS)内固定来治疗DISH相关的椎体骨折。我们报告一名87岁男性患者,患有与DISH相关的T11椎体骨折。尽管患者年龄较大且有多种合并症,但他接受了一次成功的手术,通过联合椎体骨水泥强化和骨水泥强化PS内固定实现了相对短节段固定。术后,患者的下背部疼痛缓解,有助于恢复正常活动。术后六个月的影像学评估证实椎体复位得以维持,且无植入物失败的迹象。在DISH相关的椎体骨折中,联合应用椎体骨水泥强化和骨水泥强化PS内固定提供了一种微创解决方案,可加速骨折稳定并改善患者预后。这种方法具有实现有效骨折稳定和显著减少术后并发症的潜力,有望用于治疗该患者群体中的疑难病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2971/10753641/14fe6311e05e/cureus-0015-00000049550-i01.jpg

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