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目的探讨椎体成形术在治疗骨质疏松性多种类型椎体骨折的疗效。方法采用椎体成形术治疗骨质疏松性胸腰椎骨折133例。按椎体骨折形态改变将骨折分为5种类型(Ⅰ型:无变形型18例,Ⅱ型:单纯压缩型31例,Ⅲ型:非后缘崩裂型49例,Ⅳ型:后缘崩裂形22例,Ⅴ型:椎管占位型13例)。结果穿刺注射技术成功率100%,术后48 h腰痛明显减轻可预期下床活动128例,症状改善但仍不能下床行走者5例。无因骨水泥椎体外渗漏造成神经受压症状的患者。随访6个月～30个月(平均10个月),症状完全缓解(CR)124例,部分缓解(PR)9例,CR率93.23%,PR率6.77%,有效率100%(有效率=CR率+PR率)。结论经皮椎体成形术治疗骨质疏松性多种类型的胸腰椎骨折是一种有效的方法。
Objective To investigate the efficacy of vertebroplasty in the treatment of various types of osteoporotic vertebral fractures. Methods 133 cases of osteoporotic thoracolumbar fractures were treated with vertebroplasty. According to vertebral fractures, fractures were divided into 5 types (type Ⅰ: 18 without deformation, type Ⅱ with simple compression type in 31 cases, type Ⅲ with 49 cases with non-posterior lip fracture, type Ⅳ with trailing edge collapse type 22 cases, Ⅴ type: 13 cases of spinal canal occupancy). Results The success rate of puncture and injection was 100%. The postoperative 48 hours low back pain was obviously relieved. 128 cases could be expected to get out of bed. The symptoms were improved but still could not get out of bed in 5 cases. No due to bone cement leakage caused by nerve compression symptoms of patients. There were 124 patients with complete remission (CR), 9 patients with partial remission (PR), the CR rate was 93.23%, the PR rate was 6.77% and the effective rate was 100% (effective rate = CR rate + PR rate). Conclusion Percutaneous vertebroplasty for the treatment of various types of osteoporotic thoracolumbar fractures is an effective method.