Release date: 2016-08-22
In the eyes of the public, rehabilitation is a simple, mechanical and long-term physiotherapy process. In the past two years, the Department of Rehabilitation Medicine of the People's Hospital of Lianzhou City (neck, shoulder, back and leg pain specialist) combined with traditional Chinese medicine techniques to carry out research "manual reduction combined with percutaneous balloon dilatation vertebroplasty" (referred to as PKP surgery), can make patients suffer Patients with vertebral compression fractures recover quickly. Because the operation is similar to "concrete grouting, which strengthens the damaged part", it is vividly called "bone cement".
Granny back pain in bed 5 months postoperative 2 days with brace easily discharged
Hu Fangzhen, chief physician of the Department of Rehabilitation Medicine, said that the PKP operation is guided by the C-arm machine and accurately positioned. Under the local anesthesia of the patient, a special trocar is inserted into the vertebral body through the vertebral body, and the balloon is expanded to restore the disease. The method of damaging the height of the vertebral body and then injecting "bone cement" into the balloon.
Hu Fangqi said that "bone cement" is polymethyl methacrylate, a special material that can be rapidly solidified, and can be rapidly solidified 10-15 minutes after injection into the vertebral body, so it is called "bone cement." ". "Bone cement" was first used in vertebral tumors, but it is mainly used for osteoporotic vertebral compression fractures. "It has obvious effects on restoring vertebral height, reducing pain, increasing vertebral strength and improving systemic related symptoms. Hu Fangtao said.
The 72-year-old Wu Po is the beneficiary of the operation. A few days ago, Wu’s mother came to the rehabilitation department and said that she had been in bed for 5 months because of the pain in her lower back. She had difficulty turning over and could not walk. Although Wu’s mother had had long-term medical treatment and acupuncture treatment, it did not seem to have any effect.
Liang Murong, a doctor in the rehabilitation department, recalled that they had carefully examined the waist and back of Wu’s mother who felt painful and found that Wu’s mother suffered from “severe osteoporotic lumbar vertebral compression fractureâ€.
The so-called "severe osteoporotic lumbar vertebral compression fracture (compression 80%)", popular point of view, that is, a certain section of Wu's lower back spine has a compressive change, "due to the various aspects of the elderly's body The function has been slowly declining, the elderly's lumbar vertebrae are prone to one or the other problem, Wu Po Po suffered from vertebral compression fractures, which is very common in the elderly population," Liang Murong said.
After Hu Fangxuan and several other physicians in the department, they believe that the most effective treatment for the treatment of Wu's vertebral compression fracture is PKP surgery.
Liang Murong said: "The patient is old, the lumbar vertebrae is heavier, and the compressed vertebrae are squashed to only 1/4, which greatly increases the difficulty of the operation. Many doctors are at a loss." The doctor has a wealth of clinical experience. He has adopted a combination of Chinese and Western medicine. He first resets the diseased vertebral body and then performs PKP surgery after successful reduction.
"The operation was very smooth. After the operation, Wu's mother's back pain was obviously relieved. After the operation, she could walk down the ground," Liang Murong said. On the second day of surgery, Wu Po was discharged from the hospital with a custom brace.
Treatment for severe patients with effective mild pain recovery and less burden
Hu Fangqi introduced that with the development of medicine in recent years, minimally invasive technology has become the mainstream of rapid rehabilitation technology. Percutaneous vertebroplasty and percutaneous balloon dilatation vertebroplasty have become the treatment of osteoporotic vertebral compression. The main treatment for fractures, while the latter (ie PKP surgery) is more common.
In 2012, the Department of Rehabilitation Medicine of Lianzhou People's Hospital began to carry out these two technologies. At present, the operation has been more mature, and the combination of Chinese and Western medicine has been used to reset the severely operative patients before surgery, so that difficult surgery becomes difficult. Simple and effective.
The patient was firstly treated with TCM method, then PKP operation, and then the patient was "tailor-made" fixed brace. It is a set of rapid rehabilitation treatment for senile thoracolumbar fractures in the Rehabilitation Medicine Department of Lianzhou People's Hospital. The method is often effective for patients with particularly severe conditions.
Hu Fangqi introduced: "In particularly severe patients, the degree of vertebral compression is large, and the posterior wall of the vertebral body is incomplete. This is a great challenge to the operation. The incomplete wall of the vertebral body is easy to cause cement leakage. The operation has certain difficulty and risk. Therefore, our department adopts the method of TCM manual reduction and PKP operation, firstly resetting the injured vertebral body part of the patient, and then performing bone cement injection after the vertebral body is retracted, so that some patients with severe thoracolumbar fractures can also Complete the surgical treatment."
It is understood that the Department of Rehabilitation Medicine has also received research support and research funding from the 2016 Guangdong Provincial Traditional Chinese Medicine Bureau for this Chinese and Western medicine treatment technology. So, in addition to rapid recovery, what are the advantages of this treatment technology? In this regard, the Department of Rehabilitation Medicine of Lianzhou People's Hospital gave a detailed explanation.
Dr. Liang Murong introduced that elderly people with compression fractures of the thoracolumbar spine need to stay in bed for more than 3 months in the past traditional treatment. Not only is the effect not good, but long-term bed rest is also prone to "cardiopulmonary complications". The family brings a heavier burden.
"The traditional surgical method is open reduction and internal fixation. This type of surgery is traumatic, bleeding, and expensive. Most elderly people are unable to withstand such major surgery. On the contrary, PKP surgery can be performed under local anesthesia. The incision is only 3-5 mm, which is equivalent to the size of soybeans, and does not require needles. The amount of bleeding is very small, so the trauma is small, the safety is high, and the patient is easy to accept." Hu Fangzhen said.
PKP surgery also has the effect of “fast pain relief and quick recoveryâ€. After injecting “bone cementâ€, “bone cement†solidifies to enhance the strength and stability of the vertebral body, and the height of the vertebral body is 70%. -90%. 10-15 minutes after surgery, the patient's pain and sitting function improved significantly, with the use of "tailor-made" brace, the patient can be discharged on the first day after surgery, thus achieving "rapid recovery."
Hu Fangqi is currently the chief surgeon of PKP surgery.
Traditional Chinese medicine reset
Before and after treatment: a is before treatment, b is after manual reduction, c is after manual reduction + PKP
Source: Nanfang Daily
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