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Vojnosanitetski pregled
2018, vol. 75, br. 10, str. 1049-1053
jezik rada: engleski
vrsta rada: prikaz slučaja
objavljeno: 25/10/2018
doi: 10.2298/VSP170130037A
Creative Commons License 4.0
Lečenje subakutnih kompresivnih fraktura osteoporotičnih pršljenova primenom perkutane vertebroplastike
aKlinički centar Republike Srpske, Klinika za opštu i abdominalnu hirurgiju, Banja Luka, Republika Srpska, BiH
bAmbulance of Brigade of Guards, Belgrade
cUniverzitet u Kragujevcu, Medicinski fakultet, Katedra za anatomiju i sudsku medicinu + Univerzitet odbrane, Medicinski fakultet Vojnomedicinske akademije, Beograd
dVojnomedicinska akademija, Klinika za ortopedsku hirurgiju i traumatologiju, Beograd
eKlinički centar Kragujevac, Klinika za ortopediju i traumatologiju
fKlinički centar Kragujevac + Univerzitet u Kragujevcu, Medicinski fakultet

e-adresa: ivanaanatom@yahoo.com

Sažetak

Uvod. Perkutana vertebroplastika (PVP), kao mini invazivni pristup u lečenju bolesnika sa kompresivnom frakturom osteoporotičnog pršljena (KFOP), obezbeđuje stabilizaciju kičmenog stuba i otklanja bol. Najčešće se primenjuje u periodu od tri do sest nedelja, pre pojave krivljenja/pogrbljenja kičme. Potpuni prestanak bola je lakše postići ako se leče 'manje zreli' prelomi. Cilj prikaza je da se pokaže da je PVP efikasna i bezbedna i kod starih fraktura. Prikaz bolesnika. Bolesnik starosti 77 godina, posle minimalne traume, zadobio je stabilnu kompresivnu frakturu tela trećeg lumbalnog (L3) pršljena koja je klinički i radiološki verifikovana. Zbog permanentnog bola i tipa frakture primarno je uključeno konzervativno lečenje (lumbosakralna ortoza-mider), analgetici i fizikalna terapija. Posle dva meseca bol je i dalje perzistirao, ali sada u torakalnom segmentu kičmenog stuba gde je dao radiološki konstatovane frakture tela osmog torakalnog (Th8) i desetog torakalnog (Th10) pršljena, bez neurološkog deficita. Ordinirana je konzervativna terapija, ali zbog perzistentnog bola 6 meseci kasnije postavljena je indikacija za operativno lečenje u smislu PVP tela Th 8 i Th 10. Bol je kupiran i bolesnik je otpušten iz klinike drugog postoperativnog dana. Kontrolni pregledi bili su uredni. Zaključak. Kod bolesnika sa stabilnom KFOP, PVP je efikasna terapija za redukciju bola i poboljšanje mobilnosti i kod preloma starih šest meseci.

Ključne reči

kičmeni pršljenovi; prelomi; prelomi; kompresivni; osteoporoza; bol; vertebroplastika; lečenje; ishod

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