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中华老年骨科与康复电子杂志 ›› 2024, Vol. 10 ›› Issue (05) : 315 -320. doi: 10.3877/cma.j.issn.2096-0263.2024.05.009

综述

骨质疏松椎体骨折的分型进展
周锐1, 罗飞1,()   
  1. 1. 400038 重庆,陆军军医大学第一附属医院骨科
  • 收稿日期:2023-10-31 出版日期:2024-10-05
  • 通信作者: 罗飞
  • 基金资助:
    国家自然科学基金资助项目(81972112)

Osteoporotic vertebral fracture-the evolution of classification and progress in treatment

Rui Zhou1, Fei Luo1,()   

  1. 1. Department of Orthopedics, the Orthopedic Surgery Center of Chinese PLA, Southwest Hospital, Army Medical University, No.30 Gaotanyan Street, Chongqing 400038, China
  • Received:2023-10-31 Published:2024-10-05
  • Corresponding author: Fei Luo
引用本文:

周锐, 罗飞. 骨质疏松椎体骨折的分型进展[J]. 中华老年骨科与康复电子杂志, 2024, 10(05): 315-320.

Rui Zhou, Fei Luo. Osteoporotic vertebral fracture-the evolution of classification and progress in treatment[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(05): 315-320.

骨质疏松性椎体骨折(OVF)是最常见的脆性骨折类型,具有发病率高,漏诊率高,致死和致残率高等特点。近年来,针对创伤导致的颈椎和胸腰椎骨折的分型和评分系统,在临床上得到广泛应用,使得对这类疾病的治疗在一定程度上得到了规范。但对于OVF的分型和治疗规范,还在不断探索中。本文回顾了自上世纪60年代以来,出现的几种重要的OVF的分型,特别是近几年来国内外出现的几种新的OVF分型以及其对OVF治疗的指导作用,为从事相关工作和研究的学者提供参考。

Osteoporotic vertebral fracture (OVF) is the most common type of fragility fracture, characterized by a high incidence rate, frequent misdiagnosis, and significant mortality and disability rates. In recent years, the classification and scoring system for cervical and thoracolumbar fractures caused by trauma has been widely used in clinical practice, leading to standardized treatment approaches for these conditions to some extent. However, the classification and treatment guidelines of OVF are still being explored. This paper provides a comprehensive review of several important OVF classifications that have emerged since the 1960s, particularly focusing on recent domestic and international advancements in OVF classifications as well as their influential impact on guiding OVF treatment. The aim is to offer valuable references for scholars engaged in related work and research.

图1 Genant半定量分型
图2 Genant半定量分型的X线表现
图3 Sugita分型
图4 Sugita分型的部分影像学表现。腰3椎体船头型骨折(a);腰椎多发凹陷型骨折(b);腰4椎体凹痕型骨折(c)
图5 Kanchiku分型
图6 OF分型
图7 OF分型的影像学表现。a:女性,65岁,胸12椎体骨折,OF 2型;b:女性,71岁,胸腰椎多发OVF,其中胸12,腰1椎体为骨水泥强化术后,腰3,腰5椎体为OF 3型新鲜骨折,腰2椎体为OF 2型陈旧骨折,腰4为OF 3型陈旧骨折;c, d, e:男性,78岁,胸12椎体OF 4型骨折(椎体整体结构消失),CT和MRI检查证实胸12椎体四壁骨折,椎体内真空裂隙征;f:女性,68岁,腰1椎体OF 4型骨折(椎体塌陷型)
表1 基于OF分型的评分系统
表2 胸腰椎骨质疏松性骨折严重程度评分(OTLICS)
图8 ASOTLF分型
图9 CSOTF分型
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