经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折

目的探讨经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的安全性和疗效。方法应用经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折30例,其中男8例、女22例,年龄55～86岁。共治疗40个椎体:单椎体23例,2个椎体4例,3个椎体3例。结果所有患者均顺利完成手术。手术时间35～138 min,术中球囊扩张压力200～300 psi(1 psi=6.89 kPa),骨水泥注射量2.5～5 ml。1例球囊术中破裂,1例发生椎旁渗漏,2例椎间隙渗漏,1例椎管内渗漏,未出现临床症状。1例术中出现血压、脉搏下降,对症处理后好转。患者疼痛症状得到明显缓解,未见神经损伤等并发症的发生。结论经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折可迅速缓解疼痛、有效恢复骨折椎体高度,明显减少骨水泥渗漏率,这种技术简单、微创、安全、疗效肯定。掌握好椎弓根穿刺、球囊扩张技术以及把握好骨水泥的推注时机等能有效降低并发症的发生。

Percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fracture

Objective To evaluate the effectiveness and safety of percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fracture.Methods A retrospective study was done on percutaneous kyphoplasty applied to 30 patients(8 males,22 females;aging 55-86 years) with osteoporotic vertebral compression fracture involving 40 vertebrae totally(single in 23 cases,double in 4 cases,three in 3 cases).Results Operation was successful in all the 30 cases with a dramatic relief in pain and no surgical complication occurred.The operation time was from 35 to 138 minutes.The balloon’s expansion pressures was from 200 to 300 psi(1 psi = 6.89 kPa),and the volume of cement injection was from 2.5 to 5.0 ml.During the procedure,balloon rupture occurred in 1 case,paraspinal leakage in 1 case,disc leakage in 2 cases and intraspinal leakage in 1 case,which led to no obvious clinical symptoms at all.One case suffered from decreased blood pressure and weak pulse during the operation,which were improved after treatment.Conclusion Percutaneous kyphoplasty can quickly release the back pain,effectively restore the height of the compressed vertebrae and significantly decrease the cement leakage.It is a simple,safe and micro-invasive therapeutic approach to osteoporotic vertebral compression fracture.