球囊扩张椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折疗效分析

目的 分析球囊扩张椎体后凸成形术(PKP,percutaneons kyphoplasty)治疗老年骨质疏松脊柱压缩骨折(OVCF,osteoporosis vertebral compression fractures)的疗效和安全性.方法 回顾本院行球囊扩张椎体后凸成形术的37例56椎老年骨质疏松脊柱压缩骨折患者,根据术前和预后的疼痛得分(VAS,visual analog scale)、椎体高度、Cobbs角大小及术后并发症评价临床疗效和安全性.结果 患者术后VAS较术前显著降低(P<0.05),椎体或腰背部疼痛明显缓解或消失;末次随访侧位X线片测得骨折椎体前、中部的高度恢复为原椎体高度的(72.34±19.36)%、(76.21±20.04)%,较术前(55.26±18.64)%、(57.17±19.13)%显著升高(P<0.05),骨折复位良好;Cobb角较术前23.1°±4.7°显著降低(P<0.05),骨折处脊柱后凸明显得到矫正;患者完成6~24个月随访,无感染、骨水泥渗漏、椎管狭窄加重、循环及呼吸系统障碍等严重并发症.结论 球囊扩张椎体后凸成形术治疗老年骨质疏松性骨折可明显缓解疼痛、恢复椎体高度和形态,且无严重并发症,疗效显著,临床安全.

Effect analyze of balloon dilation Percutaneous Kyphoplasty for aged Osteoporosis Vertebral Compression Fractures

Objective To analyze the efficacy and safety of percutaneons kyphoplasty（PKP） in the treatment of aged osteoporosis vertebral compression fractures（OVCF）.Methods 37 cases of OVCF（56 vertebrae） received from 2008 to 2011 and inflicted balloon dilation PKP were retrospectively analyzed,and the efficacy and safety were estimated through preoperative and postoperative indicators including the visual analogue scale（VAS）score,and the anterior and midline vertebral heights for fractured vertebrae,as well as Cobb angle of the vertebrae.Results The postoperative patients’ VAS score was significantly reduced than that of pre-operation（P〈0.05）,and the pain of suffers was relieved or disappeared obviously.The rate of postoperative anterior and midline vertebral heights for fractured vertebrae were（72.34±19.36）% and（76.21±20.04）%,which were significantly recovered than pre-operation（P〈0.05）.The postoperative Cobb angle was（17.1±3.1）,which was decreased significantly than pre-operation（23.1°±4.7°）（P〈0.05）.All patients were followed up for 6-24 months and none serious complication such as infections,bone cement leakage,spinal canal narrowing,circulatory and respiratory disorders occurred.Conclusion The balloon dilation PKP is effective and safe to treat aged osteoporosis vertebral compression fractures which can obviously relieve the pain and recover the shape and function of fractured vertebrae.