胸椎骨质疏松椎体新鲜压缩骨折椎体成形术的临床研究

目的探讨胸椎骨质疏松新鲜压缩骨折椎体成形术的临床治疗效果和手术注意事项。方法在C型臂X线机监视引导下,对61例胸椎骨质疏松性新鲜椎体压缩骨折患者经皮穿刺椎体成形术(PVP)。共对93个椎体(61例)进行了PVP手术。术后第1天、1周、一月、三月、半年对疼痛缓解进行随访和评价。结果各椎体内骨水泥注射剂量2.5～4ml,术中未发生并发症,术后疼痛明显缓解或消失者54例。VAS术前评分8.42±1.96,术后2.76±1.64。术前与术后比较,统计学有显著性差异(P<0.01);术后各时间点VAS评分比较,统计学无显著性差异(P>0.05)。结论经皮穿刺椎体成形术是一种治疗胸椎骨质疏松新鲜椎体压缩骨折缓解疼痛快速、安全、有效的方法,但也是一种相对高风险的手术。

Thoracic Vertebral Body Osteoporotic Fracture Treated With Percutaneous Vertebroplasty

Objective To evaluate the effectiveness and procedure of percutaneous vertebroplasty(PVP)for the treatment of the pain caused by thoracic vertebral body osteoporotic fracture.Methods 61 cases suffering from fresh thoracic vertebral body osteoporotic frac-tures,underwent PVP guided by C-arm fluoroscopy in prone position.Visual analgesic scale(VAS)were measured in each patient at 1 day,1 week,1 month,6 months post-PVP.Results PVP procedures were successful in 93 vertebral bodies of compression fracture.The volume of polymethylmethacrylate(PMMA)injected into each vertebral body was from 2.5 ml to 4 ml without serious complication,54 patients had significant relief of pain after the procedure.Before PVP,the VAS score was 8.42 ± 1.96 compared to a score of 2.76 ± 1.64 after operation.The mean difference in VAS score was significant(p <0.01).The mean difference in VAS score was not significant(p >0.05)at 1 day,1 week,1 month,3 months and 6 months after PVP.Conclusion Percutaneous vertebroplasty is a safe and rapid effective method in treatment of the pain caused by thoracic vertebral body osteoporotic fractures,but also is a relatively complicated and high risk operation.