单侧穿刺经皮椎体后凸成形术治疗重度骨质疏松性椎体压缩性骨折

目的：探讨单侧穿刺经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗重度骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture，OVCF）的可行性及临床疗效。方法：2007年4月-2011年10月采用单侧穿刺PKP治疗重度OVCF 15例。于术前、术后3d及末次随访时进行VAS评分并测量骨折椎体前中柱平均高度和伤椎后凸角，于术前及末次随访时进行Oswestry功能障碍指数（ODI）评分。结果：15例20个椎体均顺利完成手术，平均骨水泥注入量2．9ml，4例5个椎体术中骨水泥渗漏至椎间盘和（或）椎旁软组织，无明显临床症状，未发生骨水泥椎管内渗漏。术后疼痛明显减轻或消失。随访6～15个月，平均9．5个月。术后3d及末次随访时的VAS评分较术前明显改善（P〈0．05），末次随访时的ODI评分较术前明显改善（P〈0．05）。椎体前中柱平均高度恢复（2．9±0．8）mm，伤椎后凸角矫正（2．0±0．5）°，1例术后发生其他椎体的继发性骨折。结论：单侧穿刺PKP治疗重度OVCF疗效满意，安全可行。

Unilateral Percutaneous Kyphoplasty Treatment of Sever Osteoporotic Vertebral Compression Fracture

Objective：To discuss the feasibility and clinical effects of unilateral percutaneous kyphoplasty （PKP）treatment of severe osteoporotic vertebral compression fracture （OVCF）.Method：From April 2007 to October 2011, unilateral PKP was employed in treating 15 eases of severe OVCF.Tbe average height of fractured central and anterior columns of vertebral body and posterior convex angle of the injured vertebrae were measured, and VAS score was obtained before the operation, 3 days after operation and during the last follow-up, respectively ; Oswestry Disability Index （ODI） was obtained before the operation and during the last follow-up, respectively.Result：The operation was smoothly performed in 20 vertebral bodies of 15 patients, with an average bone cement injection of 2.9 ml ; leakage of bone cement to intervertebral disc and （or） paravertebral soft tissues during the operation occurred in 5 vertebral bodies of 4 cases without obvious clinical symptoms ; bone cement leakage into spinal canal was not observed.Pain was alleviated considerable or completely disappeared after the operation.The follow-up lasted for 6 to 15 months, averaging 9.5 months.The VAS score 3 d after the operation and during the last follow-up was significantly improved compared with that before the operation （P〈0.05） ; ODI 3 during the last follow-up was also significantly improved compared to that before the operation （P〈0.05）.The average height of fractured central and anterior columns of vertebral body was restored by （2.9 ± 0.8）mm and the posterior convex angle of the injured vertebrae was corrected by（2.0 ± 0.5）°.Secondary fracture of other vertebral bodies after the operation was found in 1 case.Conclusion：Unilateral PKP treatment of sever OVCF is safe and feasible with satisfactory effects.