多发性骨质疏松性椎体压缩骨折行经皮椎体成形及预防性椎体成形的对照研究

发布时间：2018-02-28 10:04

本文关键词： 骨质疏松性椎体骨折预防性椎体成形术新发骨折　出处：《山西医科大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:对骨质疏松造成的多发性椎体压缩骨折行经皮椎体成形术时,同时对危险椎体行预防性成形术的效果进行分析。方法:收集整理于2010年5月1日至2013年10月31日期间,因骨质疏松造成的椎体压缩骨折在我院行经皮椎体成形术的患者资料,根据是否进行预防性椎体成形分为两组。A组为2010年5月1日~2012年1月31日,对55例多发性骨质疏松性椎体压缩骨折(两个及以上椎体)患者进行经皮椎体成形术。B组为2012年5月1日~2013年10月31日收治多发性骨质疏松性椎体压缩骨折患者62例,根据脊柱MRI决定需要强化的责任椎体,同时对危险椎体进行预防性成形术。术后每3个月随访拍脊柱正侧位X线片,有疼痛者及时行MRI检查,随访至术后12个月,统计新发骨折的发生率及并发症,评价预防性椎体成形的效果。结果:A组只对责任椎体行PVP的55例患者,随访至第3个月时,有16例(29%)周围椎体出现新发骨折;随访至第12个月时,有23例(42%)出现新发骨折。新发的椎体压缩骨折71%是位于责任椎体的相邻椎体;行预防性成形的62例患者,术后随访至第3个月,有5例(8.1%)周围椎体出现新发骨折;至第12个月时,有10例(16.1%)发生远离强化椎体的新发骨折。两组比较新发骨折发生率有显著性差异(t=15.2,P0.001)。强化椎体(A组)的骨水泥渗漏率31%,预防性强化椎体(B组)的骨水泥渗漏率4.8%,无1例出现肺栓塞。结论:预防性的经皮椎体成形术可以有效预防和减少多发性骨质疏松性椎体压缩骨折椎体强化后邻近椎体的再骨折。
[Abstract]:Objective: to analyze the effect of percutaneous vertebroplasty for multiple vertebral compression fractures caused by osteoporosis, and to analyze the effect of prophylactic vertebroplasty on dangerous vertebrae. Methods: from May 1st 2010 to October 31st 2013, According to the data of patients with vertebral compression fracture caused by osteoporosis who underwent percutaneous vertebroplasty in our hospital, the patients were divided into two groups: group A from May 1st 2010 to January 31st 2012. Fifty-five patients with multiple osteoporotic vertebral compression fractures (two or more vertebrae) were treated with percutaneous vertebroplasty. Group B received 62 patients with multiple osteoporotic vertebral compression fractures from May 1st 2012 to October 31st 2013. According to the MRI of the spine, the responsible vertebral body should be strengthened, and the dangerous vertebrae should be treated with prophylactic vertebroplasty. Every 3 months after operation, X-ray films of the spine and lateral position were taken, and the patients with pain were examined with MRI in time, and followed up until 12 months after the operation. The incidence and complications of new fractures were analyzed and the effect of prophylactic vertebroplasty was evaluated. Results in group A, 55 cases of PVP were performed only on the responsible vertebrae. At the third month of follow-up, 16 cases of new fractures appeared in the surrounding vertebral bodies. After 12 months of follow-up, 23 patients had new fractures. 71% of the new vertebral compression fractures were adjacent vertebrae located in the responsible vertebrae. 62 patients who underwent prophylaxis were followed up until the third month after operation. New fractures occurred in the surrounding vertebrae in 5 cases, and at 12 months, There were significant differences between the two groups in the incidence of new fractures. There was a significant difference between the two groups in the incidence of new fractures. The leakage rate of bone cement in group A (group A) and group B (group B) were significantly higher than those in group B (group B), and the rate of leakage of bone cement in group B (group B) was significantly higher than that in group B (P < 0.05). Conclusion: prophylactic percutaneous vertebroplasty can effectively prevent and reduce the refracture of the adjacent vertebral body after vertebral body enhancement in multiple osteoporotic vertebral compression fracture.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R687.3

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