老年骨质疏松性胸腰椎压缩骨折治疗研究进展

发布时间：2018-02-26 03:09

本文关键词： 骨质疏松症胸腰椎压缩性骨折研究进展　出处：《中华中医药杂志》2017年02期 　论文类型：期刊论文

【摘要】：通过总结目前有关骨质疏松性椎体压缩骨折(OVCF)的治疗研究进展,包括非手术和手术治疗及数字化骨科技术的应用,比较不同治疗方法的利弊并加以探讨。非手术治疗包括卧床休息、药物、物理、中医药、运动康复、中医正骨手法的治疗方面,从改善临床症状、减少并发症、促进成骨、恢复椎体高度、减少邻近椎体的骨折等方面均有显著疗效。手术治疗方面经皮椎体成形术(PVP)是经典术式,镇痛效果好,但易发骨水泥渗漏且椎体高度恢复不理想;经皮球囊扩张椎体后凸成形术(PKP)椎体高度恢复较好,骨水泥注入量较大但渗漏率低;Sky骨扩张系统后凸成形术(SKP)矫形效果显著但较易破坏终板,且椎体高度的维持能力尚有待明确;Opti Mesh椎体成形术可优化填充材料,最大程度还原术后病椎内部的生理环境,但手术易损伤椎旁组织;Cortoss骨水泥毒性小、聚合温度低、可模拟椎体刚度,但实际临床疗效有待明确。随着新材料、新技术的不断完善与相互结合,在数字化骨科技术的深入应用中,保守与手术治疗OVCF将获得更安全、有效的临床治疗结果,并且能够揭示胸腰椎单纯压缩性骨折的作用机制与其对相邻椎体和椎间盘压应力的影响的差异性以及治疗后对脊柱功能的影响,为临床提供治疗依据。
[Abstract]:In this paper, the recent advances in the treatment of osteoporotic vertebral compression fractures (OVCFS) are summarized, including the application of non-operative and surgical treatment and digital orthopedic techniques. The advantages and disadvantages of different treatment methods are compared and discussed. Non-operative treatment includes bed rest, medicine, physics, traditional Chinese medicine, sports rehabilitation, bone manipulation, from improving clinical symptoms, reducing complications, promoting osteogenesis, In the surgical treatment, percutaneous vertebroplasty (PVP) is a classical procedure with good analgesic effect, but it is prone to bone cement leakage and the recovery of vertebral body height is not satisfactory. Percutaneous kyphoplasty with percutaneous balloon kyphoplasty (PKP) had a better recovery of vertebral height, a large amount of bone cement injection but a low leakage rate. The orthopedic effect of kyphoplasty with kyphoplasty was significant but easy to destroy the end-plate. The ability of maintaining the height of vertebrae remains to be determined. Opti Mesh vertebroplasty can optimize the filling material and minimize the physiological environment of the diseased vertebrae after operation. However, the cortoss bone cement is easily damaged in the operation, but the toxicity of cortoss bone cement is low, and the polymerization temperature is low. The stiffness of vertebral body can be simulated, but the actual clinical effect needs to be clear. With the continuous improvement and mutual combination of new materials and new techniques, conservative and surgical treatment of OVCF will be safer in the further application of digital orthopedic technology. The results of effective clinical treatment can reveal the difference between the mechanism of simple compression fracture of thoracolumbar vertebrae and the compressive stress of adjacent vertebrae and intervertebral disc, and the effect on spinal function after treatment, which provides the basis for clinical treatment.
【作者单位】：甘肃中医药大学;甘肃中医药大学附属医院;
【基金】：国家自然科学基金项目(No.81560780) 甘肃中医药大学中青年科研基金项目(No.ZQ2014-22)~~
【分类号】：R580;R683

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