经皮后凸成形术治疗骨质疏松性骨折合并椎体内裂隙征的疗效及并发症分析

目的评价经皮后凸成形术治疗骨质疏松性骨折合并椎体内裂隙征的临床疗效,同时分析相关并发症。方法 2005年8月～2009年12月,29例单椎体骨质疏松性骨折合并椎体裂隙征患者行经皮后凸成形术治疗。记录手术前后及末次随访的疼痛视觉模拟量表（visual analogue scale,VAS）评分及Oswestry功能障碍指数（Oswestry disa-bility index,ODI）,同时在侧位X线片上测量手术前后及末次随访时患椎后凸角及前高,计算椎体压缩率,分析骨水泥灌注形态及渗漏等情况。结果所有患者得到了12～52个月随访,平均33.6个月。术后平均后凸角矫正7.9°,平均椎体压缩率恢复16.6%,平均VAS及ODI分别改善5.7和39.8。5例患者发生骨水泥渗出,3例为椎间盘内渗漏;1例患者发生邻椎骨折。结论经皮后凸成形术可显著缓解骨质疏松性骨折合并椎体内裂隙征患者的疼痛,改善其功能,并能一定程度上恢复椎体高度和后凸角度。

Clinical outcomes and complications of percutaneous kyphoplasty for osteoporotic fracture combined with intravertebral clefts

Objective To evaluate clinical outcomes and complications of percutaneous kyphoplasty(PKP) in treatment of osteoporotic fracture combined with intravertebral clefts(IVC).Methods From August 2005 to December 2009,29 single-vertebra osteoporotic fracture patients with IVC underwent PKP.Visual analogue scale(VAS) scores and Oswestry disability index(ODI) were recorded before operation,after operation and at the final follow-up.Meanwhile,kyphotic angle and anterior vertebral height were measured,and the compression rate was calculated.Cement patterns of opacification and leakage were also analyzed.Results The duration of mean follow-up in all the patients was 33.6 months(range from 12 to 52 months).After the operation,the mean kyphotic angle was corrected 7.9°,and the compression ratio was decreased by 16.6%.The VAS scores and ODI were improved by 5.7 and 39.8,respectively.Cement leakage was observed in 5 patients,of whom three had intradiscal leakage.One patient had adjacent vertebral fractures.Conclusion PKP can obviously relieve the pain and effectively improve the functional activity,recover the vertebral height and correct the kyphotic angle of patients with osteoporotic fracture and intravertebral cleft.