摘要
目的分析骨质疏松脊椎压缩性骨折的特点.方法以264例各种原因的骨质疏松脊椎压缩性骨折为基础,分析其临床表现、放射学和治疗等方面的特点.结果单处骨折122例,2处骨折84例,2处以上骨折58例.201例有外伤史,63例无外伤史.初诊时,局部有疼痛者210例,有明显脊柱后凸畸形者138例,伴有神经功能损伤6例.椎体前后缘呈不同程度压缩,以轴向压缩为主、周围爆裂较轻,且骨质疏松越严重,脊椎爆裂样骨折越不典型,常常无法区分压缩型和爆裂型骨折.骨折早期仅8例进行了开放性手术,7例行椎体成形术;249例行非手术治疗中,50例卧床8周后下地活动,124例卧床4～6周后下地活动,80例卧床时间不足3周.经随访,非手术治疗组有106例因明显腰背痛需经常口服或外用止痛药,有71例发生进展性后凸畸形,其中2例出现神经功能损伤.结论骨质疏松脊椎压缩性骨折与发生于青壮年患者的非骨质疏松脊椎压缩性骨折在临床表现、放射学和治疗等方面有很大差异.
Objective To analyse characteristics of compressive fracture of spine with osteoporosis. Methods Based on the basis of 264 cases of compressive fractures of spine with osteoporosis, the characteristics in clinic, radiology and treatment were analysed. Results Their age were 38-92 years old, averaged 63. Fracture location was found in one level in 122 cases, two levels in 84 cases and more than two levels in 58 cases. Two hundred and one cases were found to have history of injuries, most of which were minors, whereas 63 cases had no history of injuries. Local pains were found in 210 cases, obvious kyphosis in 138 cases and neurologic injuries in 6 cases. Both of the anterior and the posterior columns compressed in some degree and burst up lightly in most cases. The more severe with osteoporosis, the more untypical with burst fracture of spine, so that it's hard to differ type of compression and type of burst fractures. Only 8 cases were open operation, and 7 had vertebroplasty, whereas 249 were nonoperation at the early stage. Of the nonoperative group, 50 cases were limited to bed for 8 weeks, 124 limited to bed for 4-6 weeks and 80 cases within 3 weeks. At follow- up of the nonoperative group, 106 cases had to take pain - killers as usual for obvious pain in the region of the injuried spine, and 71 cases developed progressive kyphosis, of which 2 cases had neurologic injuries. Conclusion The characteristics of compressive fracture of spine with osteoporosis in clinic, radiology and treatments are different from these of traumatic compressive fracture of spine, which mostly occur in the young and mid - age groups.
出处
《骨与关节损伤杂志》
2004年第10期649-651,共3页
The Journal of Bone and Joint Injury
