经皮椎体后凸成形术治疗老年胸腰椎骨折

目的总结老年胸腰椎骨折患者行经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）的疗效。方法5例老年胸腰椎骨折患者,平均年龄65.3（50-74）岁,外伤性骨折4例,病理性骨折1例。并发糖尿病、心脑血管疾病各1例。均予PKP治疗。结果手术顺利,术中发生骨水泥漏2例,无神经损伤表现。手术前后X线片比较,椎体高度平均恢复86%（50%-95%）。疗效评价：优3例,良2例。术后除1例仍有疼痛外,4例疼痛消失。出院后平均随访2.3月,椎体高度无丢失,骨水泥形态无改变。结论对于老年人胸腰椎骨折而言,PKP是一种有效、安全的微创手术,能够迅速改善临床症状,重建脊柱稳定性,近期疗效较好。

Percutaneous Kyphoplasty for Thoracolumbar Fracture in Aged Patients

Objective To evaluate the effect of percutaneous kyphoplasty（PKP） in treatment of thoracolumbar fractures for aged patients.Methods 5 thoracolumbar fracture cases with average age 65.3 years were treated by PKP.Among them,there were traumatic fracture in 4 and pathological fracture in another.2 cases were complicated by diabetes or cardio-cerebrovascular disease.Results Bone cement leakage was found in 2 cases during the operation,but no nerve injury occurred.The vertebral height was improved to 50%～90%（average 86%）.The therapeutic outcome showed excellent in 3 and good in 2.The symptom of back pain was disappeared in 4 and remained in 1.Neither vertebral height loss nor bone cement change was observed during the average 2.3 months follow-up,Conclusion PKP is an effective,safe and mini-invasive procedure for thoracolumbar fracture in aged patients,and it can achieved good results with pain relief and spinal stability reconstruction in short term.