Posterior spinal shortening for paraplegia after vertebral collapse caused by osteoporosis
Posterior spinal shortening for paraplegia after vertebral collapse caused by osteoporosis
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DOI：
10.1097/00007632-200011010-00018
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发表时间：
2000-11-01
期刊：
影响因子：
3
通讯作者：
Nakamura, H
中科院分区：
文献类型：
--
作者：
Saita, K;Hoshino, Y;Nakamura, H
研究设计.病例报告：一名因骨质疏松症导致脊椎塌陷后接受新手术治疗截瘫的患者。目的。提出一种新的后路脊柱融合术治疗腰椎间盘突出症的方法。本文报告一位因骨质疏松症而导致脊椎塌陷的截瘫病人，接受手术治疗。然而，手术是困难的，因为植入物，如钩和螺钉往往在治疗过程中脱落。在这种治疗中，这些植入物对退行性脊柱的固定力差是一个具有挑战性的问题。当通过切除脊柱的后部并施加压缩力来缩短骨折的椎骨时，产生短椎骨。结果：胸椎后凸畸形减小，上胸椎下腹侧推力减小。一位74岁的T12椎体塌陷的女性用这种新方法治疗。术后外侧Cobb角（T10-L2）从26度降至4度。缩短的椎体愈合，33个月后，植入物未脱位，未观察到矫正丢失。脊柱后路短缩术可作为治疗腰椎骨折后迟发性截瘫的一种选择。
Study Design. Case report of a patient who underwent a new surgical procedure for paraplegia after vertebral collapse due to osteoporosis.Objectives. To propose a new approach to posterior spinal fusion surgery for osteoporotic patients.Summary of Background Data. Surgical treatment was performed on a paraplegic patient after vertebral collapse due to osteoporosis. However, the surgery was difficult because implants such as hooks and screws often dislodged during the treatment. The poor holding power of these implants to the osteoporotic spine is a challenging problem in this treatment.Methods. When a fractured vertebra is shortened by resecting the posterior part of the spine and the application of a compression force, a short vertebra is produced. As a result, the thoracic kyphosis decreases a nd the force pushing the upper thoracic spine inferio-ventrally also decreases.Results. A 74-year-old woman with T12 vertebral collapse was treated with this new method. Lateral Cobb angle (T10-L2) was reduced from 26 to 4 degrees after surgery. The shortened vertebral body united, and after 33 months, the implant had not dislodged and no loss of correction was seen.Conclusion. The posterior spinal shortening can be a choice for treating delayed paraplegia after osteoporotic vertebral fracture.