经皮穿刺椎体成形术治疗老年骨质疏松性椎体压缩性骨折71例临床分析

目的 探讨经皮穿刺椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折71例的临床疗效.方法 选取71例老年骨质疏松性椎体压缩性骨折患者接受了PVP治疗.患者均有明显胸背部疼痛,查体叩痛点与MR提示新鲜骨折椎体相符.在C臂X线机透视引导下,经单侧或双侧椎弓根入路PVP骨水泥注入量为3～6ml,平均4.5 ml,完成75个椎体成形术.术后患者随访3～12个月,平均7个月.结果 71例中,有效率93.0%.4个椎体术中出现骨水泥椎旁静脉丛渗漏,11个椎体骨水泥椎间盘渗漏,13个椎体骨水泥椎旁软组织渗漏,无椎间孔和椎管内渗漏.结论 PVP能够有效缓解骨质疏松性椎体压缩性骨折引起的疼痛及功能障碍症状,治疗骨质疏松性胸腰椎压缩骨折具有广阔的应用前景.其优点是创伤小、操作简便、安全性高、效果确定.

PVP in the treatment of elderly osteoporotic vertebral compression fracture: clinical analysis of 71 cases

Objective To explore the clinical curative effect of percutaneous vertebroplasty （PVP） on elderly osteoporotic vertebral com- pression fracture. Methods Seventy - one patients with elderly osteoporotic vertebral fracture （75 vertebral bodies） received PVP. All patients had obvious chest/back pain, physical examination and MR indicated the fracture was new. Amount of bone cement injected per vertebral body was 3 - 6 ml （ average 4.5 ml）. The injection was performed via unilateral or bilateral pedicle of vertebral arch approach under the guidance of C - arm fluoroscopy. Postoperative patients were followed up for 3 to 12 months （ average 7 months）. Results Of 71 patients treated with PVP, the effective rate was 93%. Bone cement leakage in vertebral vein plexus, intervertebral disc, and perivertebral soft tissues were found in 4, 11 and 13 vertebral bodies respectively. The leakage was not observed in intervertebral foramen and spinal canal. Conclusion PVP can effectively facili- tate pain relieve and function recovery caused by osteoporotic vertebral compression fracture. It is minimal invasive, safe, and simple in operation.