椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折

目的探讨经皮穿刺球囊扩张椎体成形术(PKP)治疗老年骨质疏松椎体压缩骨折(VCFs)的初步疗效。方法在C臂X线机监视下经皮穿刺,经椎弓根建立管性通道,将可扩张球囊置入伤椎,高压注入造影剂使球囊扩张,X线确认椎体骨折基本复位,骨水泥注入扩张产生的空腔。结果46例患者术后腰背部疼痛明显缓解或消失,术后均行X线检查,病椎椎体高度恢复满意,后凸畸形矫正15～28°,平均20°,骨折脊柱后凸明显得到矫正,有2例骨水泥渗漏,未发生严重并发症。随访5～18个月,平均6.5个月,未发现强化椎体高度丢失。1例L2椎体骨折PKP治疗后6个月出现T11椎体新鲜骨折。结论应用PKP治疗老年骨质疏松性椎体压缩骨折能明显改善患者疼痛症状,恢复椎体高度,矫正后凸畸形,是一种安全的微创方法。

TREATM ENT OF SPINAL COM PRESSIVE FRACTURE IN AGED PATIENTS WITH OSTEOPOROSIS BY PERCUTANEOUS KYPHOPLASTY

Objective To assess the safety and efficacy of pereutaneous kypboplasty （PKP） in the treatment of vertebral body compression fraeturos （VCF） in elderly patients with osteoporosis. Methods 46 aged patients with VCF were reviewed. Pereutaneous puncture was guided by C -ann image intensifier,and a canal was created in he pediele, A balloon was intredueed into the fractured vertebra through the canal, and expanded with radiopaque contrast medium injected into the balloon under high pressure. After the compression fracture vertebra was reduced as verified by X - ray, bone cement was injected into the new - formed cavity. Results Back pain disappeared or relieved in all 46 cases postoperatively. The X - ray examinations were performed postoeratively which revealed great improvement of the vertebral height. The mean change in kyphosis angle from the preoperative to the postoperative examination was 20° （range, 15° to 28°）. There were 2 eases occurred bone cement leakage, no complications were found. The average duration of the follow - up was 6.5 months （ range,5 to 18 months）. There was no collapse of vertebral body during the follow - up. 1 ease of compression fracture of L2 occurred fresh vertebra fracture of T11 in 6 months. Conclusion PKP is a safe and minimally invasive way for the treatment of osteoporotie vertebral compression fracture which provides significant pain relief and improvement of the vertebral height as well as the correction of kyphosis abnormality.