Objective To explore the peri-operative treatment and clinical efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures. Methods The clinical data of 15 patients with severe vertebral osteoporotic compression fractures were retrospectively analyzed from August 2005 to April 2009. The average age of the patients was 63. 1 years old. They had no severe basal diseases. They were all treated with posterior pedicle screw fixation strengthened with bone cement combined with vertebroplasty. All patients were followed up for 10-38 months (21 months in average) after the operation. Results All patients could tolerate the surgery and the average operating time was 106. 7 ±5. 3 min. The average bleeding volume was 370 ± 6. 1 ml. The twist and back pain were significantly ameliorated after the surgery. The height of vertebral body recovered back to 90% after operation. The height loss was not obvious during the following up. Conclusion The efficacy of pedicle screw fixation strengthened with bone cement combined with vertebroplasty for the treatment of severe osteoporotic fractures is good at correcting fracture and maintaining the recovering effect of the vertebra. The key point of this therapy is the surgical indication and osteoporotic medicine treatment.%目的 探讨骨水泥强化椎弓根钉固定联合椎体成形术治疗严重骨质疏松性椎体压缩骨折的围术期处理和临床疗效.方法 回顾分析2005年8月～ 2009年4月收治的15例严重骨质疏松性椎体压缩骨折患者的临床资料,平均63.1岁,无重大基础病存在,经脊柱后入路椎弓根钉撑开复位,钉道采用骨水泥灌注加强并行经伤椎椎体成形术.术后随访10～ 38个月,平均21月.结果 均耐受手术,平均手术时间为106.7±5.3min；平均失血量为370±6.1ml,术后腰背痛明显改善,椎体高度恢复至90％左右,随访椎体高度角度丢失不明显.结论 应用骨水泥强化椎弓根钉固定联合椎体成形术治疗严重骨质疏松性椎体压缩骨折,矫正及维持椎体复位效果好,手术适应证的选择和骨质疏松药物治疗是关键.
展开▼
