骨质疏松性椎体压缩性骨折经皮椎体成形术后再发骨折的治疗

目的 探讨骨质疏松性椎体压缩性骨折经皮椎体成形术(PVP)术后再发骨折的治疗方法.方法 2010年1月至2012年12月,收治骨质疏松性椎体压缩性骨折PVP术后再发骨折患者43例,再次行PVP治疗,术前及术后进行视觉模拟疼痛评分(VAS)及自理生活能力评估(ADL).结果 所有患者采用PVP治疗均获成功,影像学并发症包括骨水泥漏入椎间盘、周围软组织、椎体周围静脉引流,但上述患者均无明显的临床症状,术后24h、3个月VAS评分分别为(3.2±1.1)、(1.7±0.9)分,ADL评分分别为(72.0±10.0)分、(95.0±15.0)分,较术前(7.7±1.4)、(33.0±13.0)分均显著改善(P＜0.01).结论 PVP手术对于骨质疏松性椎体压缩性骨折已行PVP治疗而再发骨折患者仍是可行和有效的,可以获得较好的疼痛缓解和功能恢复的效果,临床并发症较少.     

骨质疏松椎体压缩性骨折PKP术后椎体再骨折的临床研究

目的 探讨骨质疏松脊柱压缩性骨折（osteoporosis vertebral compression fracture,OVCFs）行经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）后再骨折的相关因素。 方法 回顾性分析了2014年1月—2015年12月行经皮椎体后凸成形术治疗骨质疏松脊柱压缩性骨折患者133例（174个椎体）。根据有无椎体新发骨折,分为再骨折组与对照组。随访时间12-18个月,平均15.5个月,统计并分析了患者性别、年龄、身高、体重、体质指数、骨密度、受伤椎体个数、骨水泥用量、注入骨水泥的方式、骨水泥是否椎间盘渗透、是否再次骨折、术后伤椎前缘恢比率及术后Cobb恢复比率等因素,并对上述因素进行统计学分析。 结果 术后再发骨折患者有28例,发生率为21%。再骨折组与对照组比较,年龄、术前骨密度、骨水泥向椎间盘渗漏、术后Cobb角度纠正程度及椎体前缘高度恢复程度在单因素分析中差异有统计学意义（P＜0.05）。多因素Logistic回归分析示术前骨密度与再骨折有显著相关性（P＜0.05）。 结论 术前骨密度、年龄、骨水泥向椎间盘渗漏、椎体高度的恢复比率及Cobb角的纠正比率是PKP术后出现其临近椎体再骨折的相关因素,但术前骨密度是其独立危险因素。     

Lordoplasty: report on early results with a new technique for the treatment of vertebral compression fractures to restore the lordosis

Cement augmentation using PMMA cement is known as an efficient treatment for osteoporotic vertebral compression fractures with a rapid release of pain in most patients and prevention of an ongoing kyphotic deformity of the vertebrae treated. However, after a vertebroplasty there is no chance to restore vertebral height. Using the technique of kyphoplasty a certain restoration of vertebral body height can be achieved. But there is a limitation of recovery due to loss of correction when deflating the kyphoplastic ballon and before injecting the cement. In addition, the instruments used are quite expensive. Lordoplasty is another technique to restore kyphosis by indirect fracture reduction as it is used with an internal fixateur. The fractured and the adjacent vertebrae are instrumented with bone cannulas bipediculary and the adjacent vertebrae are augmentated with cement. After curing of the cement the fractured vertebra is reduced by applying a lordotic moment via the cannulas. While maintaining the pretension the fractured vertebra is reinforced. We performed a prospective trial of 26 patients with a lordoplastic procedure. There was a pain relief of about 87% and a significant decrease in VAS value from 7.3 to 1.9. Due to lordoplasty there was a significant and permanent correction in vertebral and segmental kyphotic angle about 15.2° and 10.0°, respectively and also a significant restoration in anterior and mid vertebral height. Lordoplasty is a minimal invasive technique to restore vertebral body height. An immediate relief of pain is achieved in most patients. The procedure is safe and cost effective.     

微创椎体后凸成形术治疗12例高龄椎体压缩性骨折

目的探讨经皮球囊扩张椎体后凸成形术治疗骨质疏松性椎体骨折的临床效果。方法采用山东龙冠球囊扩张系列骨水泥充填对12例骨质疏松性椎体骨折患者（共13个椎体）,在C型臂X光机透视下行经皮椎弓根椎体后凸成形术,平均随访3个月。结果所有患者腰背痛症状均在术后2-24h缓解,第3天能下地行走,随访3个月后病情稳定。结论采用椎体后凸成形术治疗骨质疏松性椎体骨折较安全且能使椎体复张,缓解疼痛,早期下地行走。     

单边穿刺PKP治疗多发椎体压缩性骨折30例临床分析

目的分析单边穿刺后凸成形术(PKP)治疗多发椎体压缩性骨折(MOVCFs)的效果及风险。方法宿迁市第一人民医院2016-01—2018-12间对30例MOVCFs患者实施单边穿刺PKP。统计手术时间、骨水泥渗漏率,以及比较术前与术后各时间点的VAS及ODI评分、椎体高度。结果(1)本组30例均顺利完成手术,手术时间(56±19.95)min,除去椎体数影响,单个椎体手术时间为(32.33±19.95)min。(2)每例注射骨水泥量3~6 mL,平均4.43 mL,术中发生骨水泥渗漏4例,但均未出现神经损伤症状,术后复查摄片无肺栓塞。(3)术后第1天、3个月、12个月的VAS、ODI评分较术前降低,差异均有统计学意义(P<0.05)。但术后各时间点的VAS、ODI评分差异无统计学意义(P>0.05)。术后第1天伤椎高度较术前明显恢复,差异有统计学意义(P<0.05);术后3个月及12个月时伤椎高度较术后第1天有所降低,差异均有统计学意义(P<0.05)。结论单边穿刺PKP治疗MOVCFs,安全、有效,但易发生伤椎高度丢失。     

脊柱压缩性骨折行经皮椎体成形术后再骨折的危险因素分析

目的: 探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)术后再骨折的相关危险因素。方法:回顾性分析2012年6月～2013年8月在苏北人民医院脊柱外科行经皮椎体成形术治疗的骨质疏松性椎体压缩骨折(OVCF)患者177例,依据是否发生再骨折,将患者分为骨折组(28例)和对照组(149例)。对两组患者相关因素进行单因素和Logistic回归分析。结果:177例患者均顺利完成手术,术后随访6-24个月,平均15.5月,发现28例(15.8%)患者发生新发骨折。单因素和Logistic回归分析显示:年龄、既往存在骨折病史、骨密度是患者出现再骨折的危险因素。结论: 高龄、既往存在其他骨折病史和低骨密度是再骨折的危险因素。     

单、双侧经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的疗效

目的:探讨经单侧或双侧椎弓根途径行椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的临床疗效。方法:回顾性分析2007年6月～2008年11月在我院行PKP治疗的97例(140个椎体)骨质疏松性椎体压缩骨折患者的临床资料,按术中经单侧或双侧椎弓根途径进行分组。单侧组均为单侧穿刺骨水泥注射过椎体中线者,共58例85个椎体,男13例,女45例,平均年龄65.3岁,单椎体36例,两椎体17例,三椎体5例。双侧组39例55个椎体,男5例,女34例,平均年龄67.1岁,单椎体24例,两椎体14例,三椎体1例。观察患者手术前后VAS评分变化、椎体平均高度、局部Cobb角改善及近远期并发症的发生情况。结果:所有患者均顺利完成手术。单侧组手术时间45±16min,骨水泥注入量3.1±1.7ml;双侧组手术时间62±27min,骨水泥注入量4.2±2.1ml,两组间比较有显著性差异(P<0.05);两组术后及末次随访时VAS评分均较术前明显降低(P<0.05),两组间比较差异无统计学意义(P>0.05);术后两组椎体平均高度及局部Cobb角较术前均有显著恢复(P<0.05),组间比较差异无显著性(P>0.05);单侧组骨水泥渗漏及邻近椎体再骨折的发生率为14.12%,双侧组为16.36%,差异亦无显著性(P>0.05)。结论:经单侧椎弓根途径穿刺骨水泥过椎体中线注射治疗骨质疏松性椎体压缩骨折可取得双侧穿刺同样满意的临床效果,且具有手术时间短、骨水泥渗漏率低等优点。     

Managements of osteoporotic vertebral compression fractures: A narrative review

Osteoporotic vertebral compression fractures (OVCFs) are the most common fragility fracture and significantly influence the quality of life in the elderly. Currently, the literature lacks a comprehensive narrative review of the management of OVCFs. The purpose of this study is to review background information, diagnosis, and surgical and non-surgical management of the OVCFs. A comprehensive search of PubMed and Google Scholar for articles in the English language between 1980 and 2021 was performed. Combinations of the following terms were used: compression fractures, vertebral compression fractures, osteoporosis, osteoporotic compression fractures, vertebroplasty, kyphoplasty, bisphosphonates, calcitonin, and osteoporosis treatments. Additional articles were also included by examining the reference list of articles found in the search. OVCFs, especially those that occur over long periods, can be asymptomatic. Symptoms of acute OVCFs include pain localized to the mid-line spine, a loss in height, and decreased mobility. The primary treatment regimens are pain control, medication management, vertebral augmentation, and anterior or posterior decompression and reconstructions. Pain control can be achieved with acetaminophen or nonsteroidal anti-inflammatory drugs for mild pain or opioids and/or calcitonin for moderate to severe pain. Bisphosphonates and denosumab are the first-line treatments for osteoporosis. Vertebroplasty and kyphoplasty are reserved for patients who have not found symptomatic relief through conservative methods and are effective in achieving pain relief. Vertebroplasty is less technical and cheaper than kyphoplasty but could have more complications. Calcium and vitamin D supplementation can have a protective and therapeutic effect. Management of OVCFs must be combined with multiple approaches. Appropriate exercises and activity modification are important in fracture prevention. Medication with different mechanisms of action is a critical long-term causal treatment strategy. The minimally invasive surgical interventions such as vertebroplasty and kyphoplasty are reserved for patients not responsive to conservative therapy and are recognized as efficient stopgap treatment methods. Posterior decompression and fixation or Anterior decompression and reconstruction may be required if neurological deficits are present. The detailed pathogenesis and related targeted treatment options still need to be developed for better clinical outcomes.     

骨质疏松性椎体压缩骨折椎体成形术后继发骨折原因分析

目的：探讨椎体成形术（percutaneous vertebroplasty,PVP）治疗骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fracture,OVCF）继发骨折发生原因和防治措施。方法：2011年1月至2013年1月,对采用PVP治疗的180例原发性骨质疏松性椎体压缩骨折进行回顾性分析,男75例,女105例;年龄68-95岁,平均（79.50±5.45）岁。依据临床症状和影像学检查,判定责任椎,行椎体成形术共362个椎,术后平均随访12个月。根据再次出现疼痛和核磁或骨扫描检查判定是否继发骨折,分继发骨折和未继发骨折两组,继发骨折组按性别不同分两组,每组分原手术椎再骨折、邻椎骨折和跳跃椎骨折3类。比较各组间年龄、性别、骨水泥注射量、骨水泥泄露、继发骨折部位、继发骨折率和继发骨折类型等情况。结果：男性椎体成形术109椎,女性椎体成形术253椎,术后继发骨折共22例27椎,其中行2次椎体成形术13例16椎,3次椎体成形术2例4椎,保守治疗7例7椎。继发骨折组和未继发骨折组年龄、性别、骨水泥注射量和骨水泥椎间隙泄露与否比较差异无统计学意义（P〉0.05）。继发骨折组内男女两组间继发骨折率、继发骨折类型差异无统计学意义（P〉0.05）,跳跃椎骨折发生率与邻椎骨折发生率差异无统计学意义（P〉0.05）。继发骨折多发生于术后半年内,而与是否单双侧注射、是否椎间隙泄露无明显关系。结论：椎体压缩骨折椎体成形术后继发骨折与性别和部位无关,术后跳跃椎骨折与邻椎骨折发生率无明显差异,不支持椎体成形术后椎体刚度增加所致邻椎应力增加继而邻椎易骨折这一生物力学观点,认为椎体成形术后继发骨折多发生于术后半年内,是骨质疏松的自然病程。     

经皮椎体成形术治疗伴有椎体内裂隙样变的脊柱压缩骨折的疗效观察

目的 :探讨经皮椎体成形术(PVP)对存在椎体内裂隙样变的骨质疏松性脊柱压缩性骨折的疗效。方法 :对2013年1月至2016年5月间收治的176例脊柱压缩性骨折患者的临床资料进行回顾性分析,所有患者进行单侧PVP手术治疗,其中37例患者存在裂隙样变,7例符合排除标准被剔除,最终观察对象为30例。30例患者中男14例,女16例,年龄60~93(77.73±9.33)岁;骨密度-2.3~-4.1(-3.16±0.48)SD。对患者术前及术后1 d、3个月、1年的VAS和ODI评分进行分析,并观察术前、术后3 d、3个月的椎体压缩百分比,评价PVP对于椎体内存在裂隙样变的压缩骨折患者的疼痛、功能及椎体高度恢复及维持情况。结果:所有患者手术顺利,且获得1年以上随访。术后1 d、3个月、1年的VAS评分分别为2.93±0.83、2.07±0.58、1.57±0.68,均较术前的7.00±1.41明显缓解(P0.01);术后1 d、3个月、1年的ODI评分分别为36.2±4.1、22.9±6.7、18.8±5.9,较术前的40.5±3.9有明显改善(P0.01)。患者术后3 d、3个月的椎体高度百分比分别为(79.26±8.57)%、(77.68±8.96)%,较术前的(72.00±12.14)%也有显著改善(P0.05)。结论 :对于存在椎体内裂隙样变的骨质疏松性压缩骨折患者,经皮椎体成形术能有效恢复椎体高度,并能明显改善患者的疼痛及功能状况。     

经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折远期并发症的Meta分析

目的:应用Meta分析评价经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的远期并发症,为临床应用提供依据。方法:计算机检索CNKI、CBM、Pub Med、The Cochrane Library(2017年第2期)、Wiley Online Library、ELSEVIER Science Direct(SDOS)数据库,检索时间均是从建库到2017年2月。收集PKP与保守治疗OVCF的相关随机对照试验(RCT)文献,经X线、CT及MRI确定诊断为胸腰椎压缩骨折;骨密度测量仪测量确定存在胸腰椎骨质疏松(T≤-2.5);年龄≥50岁,病程6个月;术后结局指标至少包括以下指标中的一项:新发椎体骨折、邻近节段椎体骨折、严重并发症、视觉模拟评分。参考Cochrane系统评价手册5.0.1提供的针对随机对照试验的评价标准对纳入文献质量进行评价。结果:共纳入5篇RCT研究,4篇为英文文献,1篇为中文文献,方法学质量评价4篇文献为4分及以上,1篇文献为3分。PKP组共计417例,保守治疗组共计458例。Meta分析结果显示,PKP组治疗后3~6个月视觉模拟评分(VAS)与保守治疗组相比有统计学意义[MD=-0.36,95%CI(-0.65,-0.07),P=0.02];在新发椎体骨折、邻近节段椎体再发骨折、严重并发症三个方面PKP组与保守治疗组无统计学差异。结论:应用PKP治疗OVCF可以降低患者疼痛VAS评分,并且不会提高新发椎体骨折、邻近节段椎体再发骨折、严重并发症的发生风险。     

经皮穿刺椎体成形术治疗骨质疏松椎体压缩骨折

目的 研究经皮穿刺椎体成形术在治疗疼痛性骨质疏松脊柱压缩骨折中的效用。方法 2年内15例有1－6个月背部、腰部疼痛伴行动障碍需止痛药治疗患（男5人、女10人），年龄58－81岁，经临床、CT及MRI评价为骨质疏松椎体压缩且近期有进展，在CT引导下完成经皮穿刺椎体成形术22例次。治疗效果采用Huskisson止痛视觉评分法评估。结果 13例患（86．7％）在24h内疼痛缓解，12例停用止痛药，余下的2例有轻微疼痛好转（13．3％）。1例患3个月后由于相邻椎体出现新的压缩而疼痛复发，二次治疗好转。结论 经皮穿刺椎体成形术用于骨质疏松椎体压缩是一种微创操作，可以立即缓解疼痛并使患很快恢复运动，是一种有价值的治疗骨质疏松压缩骨折的方法。     

多节段骨质疏松性椎体压缩骨折一期强化治疗的疗效及安全性评估

【摘要】〓目的〓探讨骨质疏松性椎体压缩骨折采用一期3个及以上致痛椎的强化术治疗的疗效、安全性及术中注意事项。方法〓回顾性分析采用一期3个及以上致痛椎的强化术治疗的骨质疏松性椎体压缩骨折患者26例,分析患者术前、术中及术后临床及影像学资料。采用视觉模拟评分(VAS)评价患者术后疼痛缓解程度。结果〓一次手术完成3个椎体强化17例,4个椎体强化8例,5个椎体强化1例。术前VAS评分平均为8.48±1.36,术后2天平均为3.08±1.24;术后3个月平均为1.96±1.17,末次随访平均为1.65±1.25,疼痛缓解明显。术后出现骨水泥少许向椎体前方外溢者7个,进入周围静脉丛者1个,但均无异常临床表现。结论〓3个及以上椎体一次性椎体强化术临床安全性高、疗效确切,在充分评估患者可以耐受的基础上可考虑施行。     

微创球囊扩张椎体后凸成形术治疗中老年胸腰椎骨质疏松压缩性骨折

目的 探讨微创球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)在骨质疏松性胸腰椎压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效及相关问题.方法 采用球囊扩张PKP治疗椎体OVCF 26例,术前患椎明显疼痛,但无神经症状及体征;术前CT示椎体后壁均完整.结果 26例患者腰背部疼痛在术后24 h缓解并下床活动,椎体高度基本恢复,后凸畸形矫正9°,无脊髓神经损伤、骨水泥漏、肺栓塞等并发症.结论 PKP治疗胸腰椎OVCF可有效缓解疼痛,部分恢复椎体高度,疗效满意.     

骨质疏松性椎体压缩骨折椎体强化术后残余腰背痛风险预测模型的构建与验证

【摘要】 目的：分析骨质疏松性椎体压缩骨折（osteoporotic vertebral compression fractures,OVCFs）患者椎体强化术（vertebral augmentation,VA）后残余腰背痛的独立危险因素,建立相关风险预测模型并进行验证。方法：本研究回顾了2016年12月～2021年2月在本院接受VA的377例OVCFs患者的临床资料,平均年龄75.63±7.27岁（65～94岁）,男性52例,女性325例。收集患者的一般资料[性别、年龄、骨密度（bone mineral density,BMD）等]、手术和影像学资料、术前及术后合并症等相关信息,术前、术后1d、出院前、术后3个月、6个月时的视觉模拟（visual analog scale,VAS）评分和Oswestry功能障碍指数（Oswestry disability index,ODI）。将术后残余腰背痛定义为术后1d原疼痛部位附近仍存在中等程度以上的腰背部疼痛（VAS评分≥4分）,按照定义将患者分为残余痛组64例,对照组313例。通过单因素分析联合Lasso回归确定最佳Logistic回归模型后进行多因素分析,探寻术后残余腰背痛的独立危险因素,进而构建Nomogram模型。应用Bootstrap完成模型内部验证,采用受试者工作特征（receiver operating characteristic,ROC）曲线、校准曲线及决策曲线分析（decision curve analysis,DCA）分别评估模型预测性能与临床实用性。结果：单因素分析及Lasso回归交叉验证最佳模型显示患者术前BMD、术前腰椎间盘突出症、术前胸腰筋膜（thoracolumbar fascia,TLF）损伤、术中小关节损伤（facet joint injury,FJI）、术后骨水泥未完全粘合骨折线是残余痛的潜在危险因素。进一步行多因素Logistic回归分析,发现上述变量仍是术后残余腰背痛的独立危险因素（P<0.05）。构建Logistic回归的可视化Nomogram模型,利用ROC曲线求出模型的C指数为0.8384（95%CI：0.7855～0.8912）,经过200次Bootstrap抽样内部验证,得出C指数为0.8326;校准曲线显示预测概率曲线与实际概率曲线接近;DCA曲线显示在1%～53%的阈值范围内,决策曲线位于None线与All线上方。结论：术前低BMD、术前腰椎间盘突出症、术前TLF损伤、术中FJI、术后骨水泥未完全粘合骨折线是OVCFs患者行VA术后残余腰背痛的独立危险因素。上述5个因素作为预测因子构建的风险预测模型对术后残余腰背痛的预测性能及临床实用性较好。     

椎体加强术在骨质疏松性椎体压缩骨折的临床应用

正椎体压缩骨折(vertebral compression fractures,VCF)通常由骨质疏松症、椎体肿瘤或脊柱外伤等原因造成,其正逐渐成为一种严重危害老年人健康的疾病。临床上骨质疏松症乃是VCF常见的病因。据文献报道,70岁以上的老年人群中VCF的发病率约为20%,而绝经后妇女中的发病率约为16%~([1])。全美每年约有70万的骨质疏松性椎体压缩骨折(OVCF)患者,其     

Outcome of percutaneous balloon kyphoplasty in vertebral compression fractures

Background:Incidence of vertebral compression fractures (VCFs) is increasing due to increase in human life expectancy and prevalence of osteoporosis. Vertebroplasty had been traditional treatment for pain, but it neither attempts to restore vertebral body height nor eliminates spinal deformity and is associated with a high rate of cement leakage. Balloon kyphoplasty involves introduction of inflatable balloon into the fractured body of vertebra for elevation of the end-plates prior to fixation of the fracture with bone cement. This study evaluates short term functional and radiological outcomes of balloon kyphoplasty. The secondary aim is to explore short-term complications of the procedure.Results:Statistically significant improvements in SF-36 (from 34.29 to 48.53, an improvement of 14.24, standard deviation (SD) - 20.08 P < 0.0001), VAS (drop of 4.49, from 6.74 to 2.24, SD - 1.44, P < 0.0001), percentage restoration of lost vertebral height (from 30.62% to 16.19%, improvement of 14.43%, SD - 15.37, P < 0.0001) and kyphotic angle correction (from 17.41° to 10.59°, improvement of 6.82, SD - 7.26°, P < 0.0001) were noted postoperatively. Six patients had cement embolism, 65 had cement leak and three had adjacent level fracture which required repeat kyphoplasty later. One patient with history of ischemic heart disease had cardiac arrest during the procedure. No patients had neurological deterioration in the followup period.Conclusions:Kyphoplasty is a safe and effective treatment for VCFs. It improves physical function, reduces pain and corrects kyphotic deformity.     

Efficacy and safety of balloon kyphoplasty in the treatment of vertebral compression fractures: a systematic review

The aim of this study is to evaluate the efficacy and safety of balloon kyphoplasty (BK) in the management of vertebral compression fractures (VCFs). This study is based on a systematic review of the literature (until October 2004) and meta-analysis of clinical studies assessing the efficacy and safety of BK in the treatment of VCFs. Estimates of effect were based on a random effects model. Meta-regression analyses were carried out where required. A total of 26 studies met the inclusion criteria. Although studies displayed considerable methodological limitations, the results of the clinical series indicate significant improvements in pain intensity, vertebral height, sagittal alignment, functional capacity, and quality of life. Compared with conventional medical management, BK afforded significant improvement in pain intensity and mobility. Likewise, a significant reduction was observed in vertebral collapse, kyphotic deformity, the development of new vertebral fractures, and hospital stay. Compared with vertebroplasty, the technique reduced the loss of height and the degree of kyphotic deformity, and afforded a significantly lower leakage rate—with no differences in relation to other variables. Regarding adverse effects, leakage affected 7% of all levels treated, while complications were recorded in 2% of the patients, and new vertebral fractures in 16%. The available evidence suggests that BK can be effective and safe in application to VCFs. However, existing studies evince substantial methodological limitations and relatively short follow-up periods. Better clinical research is required to determine the capacity of BK to avoid the functional and physiological sequelae of VCFs and to define the true role of the technique among the existing therapeutic options.     

椎体后凸成形术治疗骨质疏松性椎体压缩性骨折疼痛的疗效分析

目的 评估经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折(OVCF)的疗效.方法 本组OVCF共468例,采用单球囊双侧扩张PKP治疗,累及T6～L5共608个椎体.其中男性93例120椎, 女性375例488椎,年龄54～94岁,平均68.2岁.单椎体360例,双椎体76例,三椎体32例.采用疼痛视觉类比评分(VAS),止痛药使用评分,活动能力评分,伤椎高度测定及胸腰段脊柱后凸角度等指标评估PKP术的疗效,同时观察并发症.结果 412例(540椎)术后得到6个月～5年随访,平均3.6年.本组术后疼痛明显缓解,术前VAS评分(8.26±0.98)分,术后2天降低到(1.63±0.83)分,末次随访时(1.85±0.89)分(P<0.01).止痛药使用评分由术前的(1.62±0.94)分下降到术后2天的(0.18±0.45)分, 末次随访时(0.21±0.54)分(P<0.01).活动能力评分由术前的(3.15±0.83)分改善到术后2天的(1.41±0.56)分,末次随访时(1.47±0.62)分(P<0.01).术后X线检查,压缩骨折的椎体高度恢复满意,术前椎体前、中份高度分别为(19.39±2.22) mm、(19.19±2.06) mm,术后2天改善到(24.47±2.04) mm、(24.38±1.93) mm,末次随访时(23.88±2.25) mm、(23.57±2.12) mm(P<0.01).胸腰段脊柱后凸Cobb角术前20.28°±4.64°,术后2天12.2°±4.36°,末次随访时13.12°±3.38°(P<0.01).本组73椎(12%)发生骨水泥渗漏,除2例术后出现神经损害表现经对症治疗缓解外,其余均无不适主诉.末次随访时,18例(4.4%)出现疼痛复发或出现新的疼痛,16例(3.9%)出现邻近椎体骨折,再次行PKP治疗.结论 PKP治疗OVCF,是一种安全、复位可靠、止痛效果确切的脊柱微创外科技术.