以可調式支架治療急性及慢性脊椎壓迫性骨折－病例報告

Treatment of Vertebral Compression Fractures with the Intravertebral Expandable System: Two Case Reports

洪沛毅(Pei-I Hung) ； 陳宏明(Hung-Ming Chen)

《北市醫學雜誌》 16卷1期 (2019/03) Pp. 90-95

https://doi.org/10.6200/TCMJ.201901_16(1).0011

摘要

脊椎壓迫性骨折多發生在60歲以上的老人，常見於跌倒後發生嚴重背痛，導致失能，主因是骨質疏鬆症。治療的趨勢，從過去的保守治療為主，慢慢轉變為傾向手術治療，尤其是年紀大、衰弱的病人。對於沒有合併神經症狀的病人，手術治療以微創椎體成形術為主，手術的目的在於止痛，讓病人及早活動，恢復功能。近年來，手術方式演進，微創支架成形術可以對塌陷的椎體作復位，恢復椎體高度，改善駝背。我們提出兩個脊椎壓迫性骨折的病例，急性和慢性各一例，以可調式支架治療，術後皆達到顯著的止痛效果，以及椎體高度回復。不論保守治療或手術治療，都只是症狀治療，根本的治療原則是要對病人的骨質疏鬆症作介入。

關鍵字

脊椎壓迫性骨折 ； 椎體成形術 ； 骨質疏鬆

並列摘要

Osteoporotic vertebral compression fractures (OVCFs) are an important health issue. It is often managed conservatively for 4 to 6 weeks to relieve the back pain. However, prolonged immobilization and excessive medication for pain control may bring enormous adverse effects on aged and frail patients. Minimally invasive surgical treatment has great advantages compared with conservative treatment in treating these fractures because it eliminates pain and functional disability, with quick recovery. Intravertebral expandable system is designed to improve the correction of the structural modifications caused by OVCFs. Its ability to stabilize and reduce OVCFs at the acute phase and for chronic kyphosis stage have already been established. We report two cases with vertebral compression fractures. One was at acute phase, and another was at chronic phase. Both were treated with the intravertebral expandable system. Significant pain relief and vertebral height restoration were achieved. The functions of traditional management or surgery are to treat the signs of OVCFs. The fundamental goal is to treat the underlying osteoporosis and prevent subsequent fracture events.

並列關鍵字

vertebral compression fracture ； vertebroplasty ； kyphosis ； height restoration