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題名 | Percutaneous Vertebroplasty for the Treatment of Osteoporotic Vertebral Compression Fractures: A Preliminary Report=以經皮膚椎體修補融合術治療骨質疏鬆所造成的脊椎骨折--初步報告 |
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作者 | 陳志豐; 李石增; 雷大雅; 吳杰才; 廖正智; | 書刊名 | 長庚醫學 |
卷期 | 25:5 2002.05[民91.05] |
頁次 | 頁306-314 |
分類號 | 415.596、415.596 |
關鍵詞 | 椎體修補融合術; 骨質疏鬆; 脊椎壓迫性骨折; 人工骨水泥; Vertebroplasty; Osteoporosis; Vertebral compression fracture; Polymethyl methacrylate; |
語文 | 英文(English) |
中文摘要 | 背景:在台灣,因骨質疏鬆所造成的脊椎骨折每年約有六萬人左右,這類骨折大多為壓迫性骨折。而這種椎體壓迫性骨折常都在只是輕微摔倒、意外跌坐就發生;且常會伴隨著嚴重背痛,尤期活動時疼痛常更加劇,而使得病患無法行動,影響日常生活。 方法:椎體修補融合術是為了補強椎體因結構上之不足而導致的脊椎壓迫性骨折。此項手術是將人工骨水泥(bone cement)置入受損之椎體內,而增強椎體強度和脊椎之穩定性,以減少病患因脊椎椎體受損而產生的慢性疼痛。 結果:截至目前為止,我們已經施行於50位病患,共86節椎體修補融合手術。其中48位病患為原發性骨質疏鬆所引起的壓迫性骨折,而次發性骨質疏鬆所引起的壓迫性骨折則有2位。病患男性11位、女性39位,年齡分佈為47-92歲、平均為72.2歲。50位病患都無手術或麻醉的併發症發生。手術後患部疼痛都可有效緩解(70-90%),而回復一般日常行走和活動。 結論:此手術可針對年齡大,骨質疏鬆病患之壓迫性骨折所引起的長期慢性疼痛做一有效的治療,也減少了年紀大病患因疼痛而需長期臥床的時間和其併發症,維持其生活品質和尊嚴。 |
英文摘要 | Background: This report assesses the efficacy and safety of percutaneous vertebroplasty for osteoporotic vertebral compression fractures and reports on preliminary results of its use. Methods: The technique was used on 50 patients with 86 painful vertebral fractures, all of which had failed to respond to earlier conservative medical treatment. The technique involves percutaneous puncture of the involved vertebra via a transpedical approach followed by injection of polymethyl methacrylate (PMMA) into the compressed vertebra. Patients were asked to quantity their degree of pain on Huskisson’s visual analogue scale (VAS) to assess the clinical symptoms and surgical results. Results: The procedures were technically successful in all patients, and no complications relating to either the anesthesia or the surgical procedure were reported. The quantity of PMMA injected per vertebral body varied from 2.5 to 12 ml according to both the position of the damaged vertebra(e) and the severity of the compression fracture. Pain, as assessed on the Huskisson’s VAS, decreased from 82[]15 mm at the baseline to 37[]22 mm on the first postoperative day, and 32[]19 mm at 1 month. Reductions in pain from the baseline to the first day and to 1 month were both statistically significant (p<0.05). All patients were able to return to their previous activity and quality of life. Conclusion: Through the expertise and attention of experienced surgeons, percutaneous vertebroplasty appears to provide a very good surgical choice for patients with vertebral compression fractures, as this surgical procedure is able to eliminate the risk of major spinal surgery, and through prompt pain relief, may provide early mobilization and rehabilitation for elderly polymorbid patients. |
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