磷酸钙骨水泥球囊撑开椎体成形术治疗骨质疏松性椎体骨折

目的：评估磷酸钙骨水泥（calciumphosphatecement，CPC）球囊撑开椎体成形术治疗骨质疏松性椎体骨折（osteoporoticvertebralfractures，OVF）的临床疗效。方法：自2009年1月至2011年1月采用CPC球囊撑开椎体成形术治疗26例（31椎体）骨质疏松性椎体骨折患者，其中男15例，女11例；年龄60-89岁，平均（71．67±4．36）岁；病程0．5～7d，平均3．2d。采用视觉模拟评分visualanalogueSCale，VAS）和功能障碍指数（oswestrydisabilityindex，ODI）对疼痛和功能进行评定。通过X线对椎体高度的丢失和后凸畸形角度进行观察。结果：所有患者获得随访，时间10-24个月，平均18个月。术前、术后24h、末次随访时VAS评分分别为7.91±1．20、3．22±1．12、1．92±0．83，ODI评分分别为40．00±1．15、17．00±2．12、13．00±1．42，椎体高度分别为（18．21±3．21）、（23．82±3．10）、（21．85±3．24）mm，后凸畸形角度分别为（18．21±3．21）°、（7．42±3．13）°、（10．01°±3．11）°，术后24h、末次随访与术前比较差异有统计学意义（P〈0．05），术后24h与末次随访比较差异无统计学意义（P〉0．05）。结论：CPC球囊撑开椎体成形术是治疗骨质疏松性椎体骨折的有效方法，能迅速缓解疼痛，有效的恢复椎体骨折椎体高度及纠正后凸畸形角度，具有创伤小、安全性好的优点。

Treatment of osteoporotic vertebral fractures with percutaneous balloon kyphoplasty using calcium phosphate cement

Objective: To assess the clinical outcomes of balloon kyphoplasty assisted with calcium phosphate cement (CPC) in treating osteoporotic vertebral fractures(OVF). Methods: From January 2009 to January 2011,26 patients with osteoporotic vertebral fractures were treated with balloon kyphoplasty assisted with CPC,including 31 vertebrae. There were 15 males and 11 females with an average age of (71.67±4.36) years old (ranged from 60 to 89 years). Course of disease was from 0.5 to 7 days with an average of 3.2 days. Clinical outcomes were assessed by the visual analogue scale (VAS) and the oswestry disability index (ODI). Vertebral height loss and kyphotic angle were measured by X-rays. Results: All patients were followed up for 10 to 24 months with an average of 18 months. Before operation,24 hours after operation and at final follow-up,VAS scores were 7.91±1.20,3.22±1.12,1.92±0.83,respectively;ODI scores were 40.00±1.15,17.00±2.12,13.00±1.42,respectivesly;vertebral heights were (18.21±3.21),(23.82±3.10),(21.85±3.24) mm,respectivesly;vertebral kyphosis angles were (18.21±3.21)°,(7.42±3.13) °,(10.01±3.11) °,respectivesly. There was significant difference between preoperation and 24 hours after operation,and between final follow-up and preoperation(P<0.05). There was no significant difference between final follow-up and 24 hours after operation(P>0.05). Conclusion: Balloon kyphoplasty assisted with calcium phosphate cement(CPC) is effective for the treatment of osteoporotic vertebral fractures(OVF),which can expeditiously relieve pain and effectively rebuild height of vertebral body and kyphotic angle,and also has advantages of minimal trauma and good security.