椎体成形术后相邻椎体骨折的诊治与原因分析

摘要

Objective To observe the diagnosis and treatment of adjacent vertebrae fracture after vertebro-plasty. Methods From December2002 to February 2009, 24 patients of adjacent vertebrae fracture after vertebro-plasty were reviewed. The cause of vertebral refracture was analyzed by CT and MRI routinely. Results The inci-dence of adjacent vertebrae fracture was 4.23% in the first year after operation in this group. The causes were relat-ed with the degree of osteoporosis, injection method and incorrect postoperative management. The diagnostic rate was improved by asking the medical history and doing physical examination and using MRI or CT for examinations. The relief of pain was significant after Percutaneous Vertebroplasty again. Conclusion Adjacent vertebrae fracture can occur after vertebroplasty and can be treated with proper postoperative management.%目的 探讨椎体成形术后相邻椎体骨折的发生原因和治疗方法.方法 对2002年12月至2009年2月椎体成形术后568例相邻椎体发生再次骨折24例,询问病史并查体,重视首次治疗资料的保管,认真与原有资料对比,常规应用MRI和CT检查进行诊断,并对发生原因进行分析,实施椎体成形术进行治疗.结果 本组病例相邻椎体骨折发生率为4.23%,全部发生在手术后1年内.发生原因主要与骨质疏松的程度、穿刺注射方法和不规范手术后管理有关.常规做MRI和CT检查,可以提高相邻椎体骨折的诊断率.再次椎体成形术疼痛缓解满意,完全缓解19例,部分缓解5例.结论 椎体成形术后可以发生相邻椎体的骨折,改进穿刺注射方法,加强手术后管理,正规康复训练和规范的全身抗骨质疏松药物治疗可以降低发生率.