[目的]比较高黏度骨水泥椎体成形术与低黏度骨水泥椎体后凸成形术治疗骨质疏松椎体压缩骨折的疗效和并发症。[方法]收集本院骨科2011年1月~2014年1月使用高黏度骨水泥椎体成形术和使用低黏度骨水泥椎体后凸成形术治疗的骨质疏松性胸腰...[目的]比较高黏度骨水泥椎体成形术与低黏度骨水泥椎体后凸成形术治疗骨质疏松椎体压缩骨折的疗效和并发症。[方法]收集本院骨科2011年1月~2014年1月使用高黏度骨水泥椎体成形术和使用低黏度骨水泥椎体后凸成形术治疗的骨质疏松性胸腰椎压缩骨折患者110例,进行回顾性研究。将患者化分为A组（高黏度骨水泥椎体成形术组42例）和B组（低黏度骨水泥椎体后凸成形术组68例）。术前统计两组患者性别比、年龄、VAS评分及骨密度值（-T值）。采用视觉模拟量表（VAS）进行疼痛评分,观察并比较两组患者的住院花费、透视时间、骨水泥用量、术后VAS评分、椎体复位高度、骨水泥静脉渗漏、椎旁渗透率、邻近椎体骨折、其他并发症等发生情况。[结果]术后随访时间为3~36个月。术前患者的年龄、性别、术前VAS评分等基本临床资料在两组间差异无统计学意义（P〉0.05）。A组手术透视时间、骨水泥用量、住院花费均少于B组（P〈0.05）;A组患者术后24h VAS评分低于B组,差异有统计学意义（P〈0.05）;两组患者术后3 d VAS评分差异无统计学意义（P〉0.05）。两组患者经俯卧位并手法复位及术后椎体高度均有明显恢复,但两者之间差异无统计学意义（P〉0.05）。A组发生椎体周围骨水泥静脉丛渗漏3例（7.1%）,椎旁骨水泥渗漏7例（16.7%）,发生邻近椎体再骨折4例（9.5%）,应激性胃溃疡1例（2.4%）;急性脑梗塞1例;B组发生椎体周围骨水泥静脉丛渗漏6例（8.8%）,椎旁骨水泥渗漏8例（11.7%）,其中B组出现1例骨水泥肺栓塞,导致严重后果,应激性胃溃疡2例（2.9%）,冠心病急性发作1例,脑脊液漏1例。两组比较差异无统计学意义（P〉0.05）。两组患者术前、术后24 h VAS评分差异具有统计学意义（P〈0.01）。[结论]高黏度骨水泥椎体成形术与低黏度骨水泥椎体后凸成形术治疗骨质疏松�展开更多
To the Editor:Osteoporosis is becoming a common,serious,and costly health problem,which causes over nine million fractures annually worldwide.[1] Currently,osteoporotic fractures are a considerable burden to public he...To the Editor:Osteoporosis is becoming a common,serious,and costly health problem,which causes over nine million fractures annually worldwide.[1] Currently,osteoporotic fractures are a considerable burden to public health services and have fairly high morbidity and mortality.[2] Vertebral fractures are the most common osteoporotic fracture and may lead to a high risk of further fracture and could be prevalent in both females and males.[3] Ling et al[4] and Ms.OS studies[5] evaluated the prevalence of vertebral fractures in Beijing and Hong Kong,respectively.However,our knowledge of the descriptive epidemiology and risk factors for vertebral fracture in China still remains poor.展开更多
The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from ver-tebral fractures secondary to osteoporosis and tumor conditio...The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from ver-tebral fractures secondary to osteoporosis and tumor conditions. In 2009, two open randomized controlled trials published in the New England Journal of Medicine questioned the value of vertebroplasty in treating ver-tebral compression fractures. Nevertheless, the prac-tice of physicians treating these conditions has barely changed. The objective of this review is to try to clarify the most important issues, based on our own experi-ence and the reported evidence about both techniques, and to guide towards the most appropriate choice of treatment of vertebral fractures, although many ques-tions still remain unanswered.展开更多
目的了解原发性骨质疏松患者椎体压缩性骨折后骨转换生化标志物早期的变化规律。方法收集在北京积水潭医院骨科住院的老年椎体骨折患者147例,明确骨折日期,检测血清1型前胶原氨基末端前肽（N-propeptide of type 1 collagen,P1NP）、1...目的了解原发性骨质疏松患者椎体压缩性骨折后骨转换生化标志物早期的变化规律。方法收集在北京积水潭医院骨科住院的老年椎体骨折患者147例,明确骨折日期,检测血清1型前胶原氨基末端前肽（N-propeptide of type 1 collagen,P1NP）、1型胶原交联羧基末端肽（C-terminal crosslinking telopeptides of type 1 collagen,CTX）、25羟维生素D（25 hydroxy vitamin D,25OHD）水平以及定量CT（quantitative CT,QCT）检查。结果 147例老年骨折患者中,女性120例（79.4%）,年龄52~90岁;椎体骨折后,P1NP在第2周即达到高峰,升高幅度为基线值1.5~2.0倍,之后基本维持在该水平,直至12周;CTX在第2周亦达到高峰,升高幅度为基线值1.5~2.0倍,之后在第3周出现了明显下降;椎体骨折后1周内P1NP上升与血磷、25OHD、患者年龄呈直线相关关系（分别为r=0.420,P=0.004;r=0.319,P=0.035;r=-0.313,P=0.036）,而同QCT-T值并无明确相关;椎体骨折后1周内CTX上升幅度与血磷水平呈有统计学意义的直线相关关系（r=0.495,P=0.001）,而与25OHD、患者年龄、QCT-T值均无明确直线相关关系。结论椎体骨折后骨代谢标志物的变化有一定规律,该指标对评估椎体骨愈合的进程,以及延迟愈合或不愈合的风险,干预骨愈合措施的作用均值得期待。展开更多
文摘[目的]比较高黏度骨水泥椎体成形术与低黏度骨水泥椎体后凸成形术治疗骨质疏松椎体压缩骨折的疗效和并发症。[方法]收集本院骨科2011年1月~2014年1月使用高黏度骨水泥椎体成形术和使用低黏度骨水泥椎体后凸成形术治疗的骨质疏松性胸腰椎压缩骨折患者110例,进行回顾性研究。将患者化分为A组（高黏度骨水泥椎体成形术组42例）和B组（低黏度骨水泥椎体后凸成形术组68例）。术前统计两组患者性别比、年龄、VAS评分及骨密度值（-T值）。采用视觉模拟量表（VAS）进行疼痛评分,观察并比较两组患者的住院花费、透视时间、骨水泥用量、术后VAS评分、椎体复位高度、骨水泥静脉渗漏、椎旁渗透率、邻近椎体骨折、其他并发症等发生情况。[结果]术后随访时间为3~36个月。术前患者的年龄、性别、术前VAS评分等基本临床资料在两组间差异无统计学意义（P〉0.05）。A组手术透视时间、骨水泥用量、住院花费均少于B组（P〈0.05）;A组患者术后24h VAS评分低于B组,差异有统计学意义（P〈0.05）;两组患者术后3 d VAS评分差异无统计学意义（P〉0.05）。两组患者经俯卧位并手法复位及术后椎体高度均有明显恢复,但两者之间差异无统计学意义（P〉0.05）。A组发生椎体周围骨水泥静脉丛渗漏3例（7.1%）,椎旁骨水泥渗漏7例（16.7%）,发生邻近椎体再骨折4例（9.5%）,应激性胃溃疡1例（2.4%）;急性脑梗塞1例;B组发生椎体周围骨水泥静脉丛渗漏6例（8.8%）,椎旁骨水泥渗漏8例（11.7%）,其中B组出现1例骨水泥肺栓塞,导致严重后果,应激性胃溃疡2例（2.9%）,冠心病急性发作1例,脑脊液漏1例。两组比较差异无统计学意义（P〉0.05）。两组患者术前、术后24 h VAS评分差异具有统计学意义（P〈0.01）。[结论]高黏度骨水泥椎体成形术与低黏度骨水泥椎体后凸成形术治疗骨质疏松�
文摘To the Editor:Osteoporosis is becoming a common,serious,and costly health problem,which causes over nine million fractures annually worldwide.[1] Currently,osteoporotic fractures are a considerable burden to public health services and have fairly high morbidity and mortality.[2] Vertebral fractures are the most common osteoporotic fracture and may lead to a high risk of further fracture and could be prevalent in both females and males.[3] Ling et al[4] and Ms.OS studies[5] evaluated the prevalence of vertebral fractures in Beijing and Hong Kong,respectively.However,our knowledge of the descriptive epidemiology and risk factors for vertebral fracture in China still remains poor.
文摘The aim of this review is to compare the effectiveness of percutaneous vertebroplasty and kyphoplasty to treat pain and improve functional outcome from ver-tebral fractures secondary to osteoporosis and tumor conditions. In 2009, two open randomized controlled trials published in the New England Journal of Medicine questioned the value of vertebroplasty in treating ver-tebral compression fractures. Nevertheless, the prac-tice of physicians treating these conditions has barely changed. The objective of this review is to try to clarify the most important issues, based on our own experi-ence and the reported evidence about both techniques, and to guide towards the most appropriate choice of treatment of vertebral fractures, although many ques-tions still remain unanswered.
文摘目的了解原发性骨质疏松患者椎体压缩性骨折后骨转换生化标志物早期的变化规律。方法收集在北京积水潭医院骨科住院的老年椎体骨折患者147例,明确骨折日期,检测血清1型前胶原氨基末端前肽（N-propeptide of type 1 collagen,P1NP）、1型胶原交联羧基末端肽（C-terminal crosslinking telopeptides of type 1 collagen,CTX）、25羟维生素D（25 hydroxy vitamin D,25OHD）水平以及定量CT（quantitative CT,QCT）检查。结果 147例老年骨折患者中,女性120例（79.4%）,年龄52~90岁;椎体骨折后,P1NP在第2周即达到高峰,升高幅度为基线值1.5~2.0倍,之后基本维持在该水平,直至12周;CTX在第2周亦达到高峰,升高幅度为基线值1.5~2.0倍,之后在第3周出现了明显下降;椎体骨折后1周内P1NP上升与血磷、25OHD、患者年龄呈直线相关关系（分别为r=0.420,P=0.004;r=0.319,P=0.035;r=-0.313,P=0.036）,而同QCT-T值并无明确相关;椎体骨折后1周内CTX上升幅度与血磷水平呈有统计学意义的直线相关关系（r=0.495,P=0.001）,而与25OHD、患者年龄、QCT-T值均无明确直线相关关系。结论椎体骨折后骨代谢标志物的变化有一定规律,该指标对评估椎体骨愈合的进程,以及延迟愈合或不愈合的风险,干预骨愈合措施的作用均值得期待。
