影像学评分对球囊扩张椎体成形术治疗骨质疏松性胸腰椎爆裂骨折的选择意义

Value of Radiological scores to Selective treat aged osteoprosis thoracolumbar burst fracture with balloon kyphoplasty

目的探讨影像学评分在选择性球囊扩张椎体成形术治疗老年骨质疏松性胸腰椎爆裂骨折的应用价值及手术疗效。方法我院自2005年1月～2010年1月,我院收治的胸腰椎骨质疏松性爆裂骨折36人,经对其影像学资料进行评分后,选择性应用球囊扩张后突椎体成形术,术后随访,术前术后测量所有病例的椎管狭窄程度、椎体前缘压缩程度、椎体后缘压缩程度、椎体中部前后径,对所得数据进行统计学分析。结果所有患者手术成功,术中未出现骨水泥渗漏、椎体骨折加重等并发症。所有患者均取得回访,平均回访时间为2.3年,术前与术后的JOA评分差异有统计学意义(P<0.05),椎体前缘压缩程度差异有统计学意义(P<0.05),椎体后缘压缩程度无明显统计学差异(P>0.05),椎体矢状面移位程度无明显统计学差异(P>0.05)。结论以影像学评分结果为参考,选择性应用球囊扩张椎体成形术治疗老年骨质疏松性胸腰腰椎爆裂骨折,临床效果满意。

Objective To evaluate the clinical results and the value of usefulness with balloon kyphoplasty in treating older osteoprosis thoracolumbar burst fracture.Methods From January 2005 to January 2010 114 thracolumbar burst fracture patients were treated in our hospital.In all the 114patients,after X-ray,CT,MRI,and bone density,36patients met the recruit criterion and were treated with balloon kyphoplasty.Pre and post operation the anterior height and posterior height of fractured vertebral body,spinal canal compromise and the distance between anterior-middle and posterior-middle were measured.They were depended to make up the recruit criterion.Results All the 36 patients were treated with balloon kyphoplasty successfully,there was no bone cement leakage,and fracture aggravate.all patient were followed up,the mean follow time is 2.3 years.There is a significant difference between pro and post operation in the JOA（P〈0.05） and the Anterior vertebral compression of fractured vertebral body（P〈0.05）.There is no statistically difference between pro and post operation in Posterior vertebral compression of fractured vertebral body（P〈0.05） and the horizontal displacement of fractured vertebral body（P〈0.05）.Conclusion Referencing the Radiological scores to select osteoprosis thracolumbar burst fracture,the balloon kyphoplasty can be a safe and effective treatment.