经皮穿刺椎体成形术治疗骨质疏松性椎体压缩性骨折不愈合

【目的】探讨经皮穿刺椎体成形术（PVP）在骨质疏松性椎体压缩性骨折（OVCF）不愈合诊治中的可行性和有效性。【方法】2009年5月至2013年5月，采用PVP治疗 OVCF不愈合患者7例，手术前后患者均行X线片、CT和MRI检查。采用疼痛视觉模拟评分（VAS），椎体前缘高度变化（AH）和楔形成角（WA）评估手术效果。【结果】7例均顺利完成手术，无严重并发症发生。所有患者均获随访，平均随访时间15．5（5～35）个月；术后疼痛明显减轻或消失，疼痛 VAS术前8．10±1．50分，术后 d3为1．25±1．04分，两者比较差异有统计学意义（P＜0．05）。末次随访 VAS为1．15±0．87分，与术后比较差异无统计学意义（P ＞0．05）。术后 AH及 WA较术前均无明显改善（P＞0．05）；末次随访与术后比较亦无明显差异（P＞0．05）。【结论】PVP能明显改善 OVCF不愈合引起的腰背部疼痛，对伤椎高度恢复无明显影响。

Percutaneous Vertebroplasty for the Treatment of Nonunion of Osteoporotic Vertebral Compression Fracture

Obj ective]To explore the feasibility and clinical efficacy of percutaneous vertebroplasty（PVP） in the diagnosis and treatment of nonunion of osteoporotic vertebral compression fracture（OVCF）.Methods]A total of 7 patients with nonunion of osteoporotic vertebral fractures undergoing PVP from May 2009 to May 2013 were analyzed retrospectively.There were 2 males and 5 females.The mean age was 72.5 years（61～88 years）.The fracture vertebrae were 3 cases in T12 ,3 cases in L1 and 1 case in L2 .The disease duration was 15～23 months.All patients received X-rays,CT and MRI examination.The surgical result was evaluated by visual analogue scale（VAS）,anterior vertebral height（AH）and wedge angle（WA）.Results]All patients were operated successfully without severe complications.All patients were followed up for 5～35 months （mean 1 5 .5 months）.Postoperative pain was alleviated obviously.Pain VAS before and at d1 after operation was （8.10±1.50）and （1.25±1.04）respectively,and there was significant difference between them（P 〈0.05）.The VAS at final follow up was （1.15±0.87）,but there was no significant difference between the fi-nal follow up and post-operation（P〉0.05）.Compared with before operation,AH and WA after operation had no obvious improvement（P〉0.05）.There was no significant difference in AH and WA between the final follow up and post-operation（P〉0.05）.Conclusion]PVP can obviously improve back pain caused by non-union of OVCF,but has no obvious effect on the recovery of the height of the diseased vertebra.