经皮穿刺球囊扩张椎体后凸成形术治疗高龄胸腰椎压缩性骨折

目的观察经皮穿刺球囊扩张椎体后凸成形术对高龄胸腰椎压缩性骨折的临床疗效及并发症。方法应用kyphoplasty技术对19例高龄患者临床确诊胸腰椎体压缩性骨折的25个椎体，在C型臂下准确定位，局部麻醉下经椎弓根路径穿刺至伤椎，正侧位透视无误，置入高压球囊，用高压注射器向球囊内渐行注入造影剂，C型臂下观察伤椎撑开高度复原即止，抽出造影剂后取出球囊，将调制好的骨水泥缓慢注入由球囊扩张而形成的椎体腔内，期间全程C型臂下监控骨水泥在伤椎内无外溢。结果19例患者术后腰背部疼痛立即消失或明显缓解，其中8例患者术后当天下地活动，11例患者术后次日下地活动。经X线检查确认伤椎高度基本恢复，椎内骨水泥分布均匀，无外溢。随访1～24个月（平均18个月），腰背部疼痛明显减轻。结论球囊扩张椎体后凸成形术具有创伤小、见效快、并发症少、疗程短等特点，是治疗高龄胸腰椎压缩性骨折的一种安全有效方法。

The clinical application of percutaneous puncture kyphoplasty in the treatment of vertebral compression fracture in the elderly

Objective To evaluate the curative effect and complications of percutaneous puncture kyphoplasty in the treatment of vertebral compression fracture in the elderly. Methods 19 cases of vertebral compression fracture in the elderly patients with disc 25 PKP technology applications were diagnosed with the accurate positioning,local anesthesia a small incision of about 0. 3cm later puncture path through vertebral pedicle to the wound vertebra,After perspective is the accurate lateral, putting into high-pressure balloon, injecting the contrast agent into the balloon with high-pressure syringe gradually. The wound vertebra is blackmai until a high degree of vertebral distraction to the recovery basis under the C-arm, and then taking the balloon out after pumping the contrast agent out. Bone cement is mixed well and injected into the cavity of the wound vertebra slowly which is the result of balloon dilation,during that time under the control of bone cement inside the wound vertebra,then puting the working column out and surgery completed. Results The low back pain of 19 patients immediately disappeared or significantly reduced after the operation, and 8 postoperative patients is up that day, 11 cases is up the following day. The degree of the wound vertebra is recovered by X-ray examination, and the bone cement evenly distributed within the wound vertebra, no spills. This group of patients are followed up for an average of 18 months(1 ～24 months) ,using visual analog and digital method to determine changes in Iow back pain. The data are paired t test,P ＜ 0.01. It have significant difference of views.Conclusion Percutaneous kyphoplasty accurate cervical disc herniation and effective disarmament of the symptoms and signs, with trauma and rapid recovery, fewer complications, shorter course of treatment and so on, and it is a safe and effective way in the treatment of vertebral compression fracture in the elderly.