[1]王桂红,钱厚龙,曹琪,等.椎体成形术和传统法治疗骨质疏松性椎体压缩骨折疗效的对比研究[J].介入放射学杂志,2008,(09):663.
 WANG Guihong,QIAN Houlong,CAO Qi,et al.Percutaneous vertebroplasty and conservative therapy for osteoporotic vertebral compression fractures:a clinical comparative study[J].journal interventional radiology,2008,(09):663.
点击复制

椎体成形术和传统法治疗骨质疏松性椎体压缩骨折疗效的对比研究()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
期数:
2008年09期
页码:
663
栏目:
临床研究
出版日期:
2008-09-15

文章信息/Info

Title:
Percutaneous vertebroplasty and conservative therapy for osteoporotic vertebral compression fractures:a clinical comparative study
作者:
王桂红钱厚龙曹琪
571000江苏省姜堰市人民医院放射科(王桂红、钱厚龙、曹琪、徐美军);骨科(王国喜);内科(孙爱民)
Author(s):
WANG Gui-hongQIAN Hou-longCAO Qi WANG Guo-xiSUN Ai -minXU Mei-jun
Department of Radiology,Jiangyan Peoples' Hospital,Jiangyan571000,China
关键词:
椎体成形术骨质疏松症椎体压缩性骨折椎体高度
分类号:
:R683.2
文献标志码:
B
摘要:
目的研究并比较椎体成形术(PVP)和保守疗法治疗骨质疏松性椎体压缩骨折的临床疗效。方法骨质疏松性椎体新鲜压缩骨折83例共104节,非随机分为2组,组1共44例58节用PVP治疗,组2共39例46节用保守治疗,比较两组治疗后随访期内疗效及椎体高度变化。结果组1患者44例PVP后1周疼痛均得到缓解,视觉疼痛评分(VAS)平均分值从术前8.5下降至2.6(平均下降5.9)。组2患者39例保守治疗后1周VAS分值无变化,在治疗后1周、1和3个月时。组1的VAS分值明显低于组2(P<0.01),6个月时两组差异无统计学意义(P>0.05)。平均随访8.9个月,组1有新发骨折3例3节,组2有2例2节,两组比较无显著差异无统计学意义(P>0.05)。PVP后1周椎体高度恢复平均为前缘2.2mm,中央2.3mm,后缘高度无变化,随访3、6个月椎体前缘、中央高度与PVP后1周时无差异(P<0.01)。保守治疗后1周椎体前缘、中央及后缘高度与治疗前比较无显著改变,3个月时椎体高度丢失平均为前缘1.9mm,中央2.1mm,6个月时与3个月无差异。在治疗3个月后,组1椎体高度明显高于组2(P<0.01)。结论PVP可迅速缓解疼痛,明显缩短病程,但6个月后两组疗效无显著差异;PVP可使新鲜压缩椎体的前缘和中央高度得到部分恢复,可显著预防椎体进一步塌陷;保守治疗在3个月内椎体高度可进一步丢失;PVP后新发骨折可能是骨质疏松症的自然发病过程。

参考文献/References:

[1]Tanigawa N,Komemushi A,Kariya S,et al.Percutaneous vertebroplasty:relationship between vertebral body bone marrow edema pattern on MR images and initial clinical response[J].Radiology,2006,239:195-200.
2]Peh WCG,Gelbart MS ,Gilula LA.Percutaneous vertebroplasty:treatment of painful vertebral compression fractures with intraosseous vacuum phenomena[J].AJR,2003,180:1411-1417.
[3]Mathis JM,Barr JD,Belkoff SM,et al.Percutaneous vertebroplasty:A developing standard of care for vertebral compression fractures[J].AJNR,2001,22:373-381.
[4]Zoarski GH,Snow P,Olan WJ ,et al.Percutaneous verte-broplasty for osteoporotic compression fractures:quantitative prospective evaluation of long-term outcomes[J].JVIR,2002,13:139-148.
[5]Legroux-Gerot I,Lormeau C,Boutry N,et al.Long-term follow up of vertebral osteoporotic fractures treated by percutaneous vertebroplasty[J].Clin Rheumatol,2004,23:310-317.
[6]Diamond TH,Bryant C,Browne L,et al.Clinical outcomes after acute osteoporotic vertebral fractures:a2-year non-randomised trial comparing percutaneous vertebroplasty with conservative therapy[J].Med J,2006,184:113-117.
[7]Hiwatashi A,Mortitani T,Numanguchi Y,et al.Increase in vertebral body height after vertebroplasty[J].AJNR,2003,24:185-189.
[8]Teng MM,Wei CJ ,Wei LC,et al.Kyphosis correction and height restoration effects of percutaneous vertebroplasty[J].AJNR,2003,24:1893-1900.
[9]Kim AK,Jensen ME,Dion JE,et al.Unilateral transpedicular percutaneous vertebroplasty:initial experience[J].Radiology,2002,222:737-741.
[10]Mathis JM.Percutaneous vertebroplasty:complication avoidance and technique optimization[J].AJNR,2003,24:1697-1706.
[11]何仕诚,滕皋军,邓钢,等.经皮椎体成形术治疗合并囊腔的骨质疏松性椎体压缩骨折[J].介入放射学杂志,2005,14:256-260.
[12]何仕诚,滕皋军,邓钢,等.添加不同类型、比例的显影剂后骨水泥性能的变化[J].介入放射学杂志,2006,15:238-241.
[13]Lindsay R,Silverman SL,Cooper C,et al.Risk of new verte 2001,285:320-323.
[14]Komemushi A,Tanigawa N,Kariya S,et al.Percutaneous vertebroplasty for osteoporotic compression fracture:Multiva-riate study of predictors of new vertebral body fracture[J].CVIR,2006,29:580-585.
[15]Lin EP,Ekholm S,Hiwatashi A,et al.Vertebroplasty:cement leakage into the disc increases the risk of new fracture of adjacent vertebral body[J].AJNR,2004,25:175-180

相似文献/References:

[1]何仕诚,滕皋军,方文,等.椎体成形术中同轴活检的应用[J].介入放射学杂志,2008,(11):796.
 HE Shicheng,TENG Gaojun,FANG Wen,et al.Coaxial biopsy of vertebral body during percutaneous vertebroplasty[J].journal interventional radiology,2008,(09):796.
[2]刘建新,李彪,武红斌.经皮椎体成形术治疗椎体转移瘤的临床应用[J].介入放射学杂志,2008,(11):817.
 LIU Jianxin,LI Biao,WU Hongbin.The clinical application of percutaneous vertebroplasty on bone metastatic tumor[J].journal interventional radiology,2008,(09):817.
[3]葛坤元,倪才方.经皮椎体成形术后相邻椎体的新发骨折[J].介入放射学杂志,2008,(12):903.
 GE Kunyuan,NI Caifang.New adjacent vertebral body fracture after percutaneous vertebroplasty[J].journal interventional radiology,2008,(09):903.
[4]陈珑,倪才方,王振堂,等.18G穿刺针行经皮椎体成形术治疗颈椎恶性重度压缩骨折[J].介入放射学杂志,2010,(07):547.
 CHEN Long,NI Caifang,WANG Zhentang,et al.Percutaneous vertebroplasty performed with an18G needle for the treatment of severe compression fracture of cervical vertebral body due to malignancy[J].journal interventional radiology,2010,(09):547.
[5]念丁芳 周军 李文华 曹庆选 夏宝枢.经皮椎体成形术在椎体压缩性骨折治疗中的应用[J].介入放射学杂志,2005,(04):416.
 NIAN Ding-fang ZHOU Jun LI Wen-hua CAO Qing-xuan XIA Bao-shu.Treatment of vertebral body compression fracture by percutaneous vertebroplasty[J].journal interventional radiology,2005,(09):416.
[6]马永红,何仕诚,腾皋军,等.椎体成形术治疗骨质疏松性椎体压缩骨折的生命质量评价[J].介入放射学杂志,2007,(05):326.
 MA Yong-hong,HE Shi-cheng,TENG Gao-jun,et al.Percutaneous vertebroplasty for osteoporotic painful vertebral compression fractures a quality of life assessment[J].journal interventional radiology,2007,(09):326.
[7]何仕诚,滕皋军,邓钢,等.添加不同类型、比例的显影剂后骨水泥性能的变化[J].介入放射学杂志,2006,(04):238.
 HE Shi-cheng,TENG Gao-jun,DENG Gang,et al.An in vitro evaluation of the property of acrylic bone cements mixed with different types and proportions of contrast agents[J].journal interventional radiology,2006,(09):238.
[8]陈珑,倪才方.椎体成形术中非骨水泥渗漏引起心血管系统的变化[J].介入放射学杂志,2006,(06):377.
 CHEN Long,NI Cai-fang.Cardiovascular changes during vertebroplasty not due to bone cement leakage[J].journal interventional radiology,2006,(09):377.
[9]胡晓晖,吴春根,张扬,等.经皮椎体后凸成形术治疗新鲜骨质疏松性椎体压缩性骨折的临床分析[J].介入放射学杂志,2009,(06):461.
 HU Xiao-hui,WU Chun-gen,ZHANG Yang,et al.Clinical evaluation of percutaneous kyphoplasty in the treatment of fresh osteoporotic vertebral compression fractures[J].journal interventional radiology,2009,(09):461.
[10]张继,吴春根,程永德,等.单侧椎弓根入路椎体成形术治疗骨质疏松性严重椎体压缩骨折[J].介入放射学杂志,2008,(02):114.
 ZHANG Ji,WU Chungen,CHENG Yongde,et al.Percutaneous vetebroplasty for severe osteoporotic vertebral body compression fractures via an uni-pedicular approach[J].journal interventional radiology,2008,(09):114.

备注/Memo

备注/Memo:
收稿日期:2008-02-26
更新日期/Last Update: 2008-09-15