过伸复位结合经皮椎体后凸成形术治疗骨质疏松性椎体骨折

目的探讨过伸复位结合经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床效果及注意事项。方法对25例骨质疏松性椎体骨折患者（共43个椎体）,在C型臂X线机透视下行过伸复位结合经皮经椎弓根球囊扩张注入骨水泥椎体后凸成形术。对术前、术后1d和术后6个月的椎体高度、Cobb′s角和疼痛评分等进行评估。结果术后23例胸背部疼痛消失,2例疼痛明显减轻,未出现神经系统损伤及肺栓塞等并发症。术后随访6～12个月,平均9.2个月,所有患者腰背痛症状均无复发,X线片示24例椎体高度未丢失,1例有邻近椎体再骨折发生。椎体高度、Cobb′s角较术前有显著改善。结论过伸复位结合经皮椎体后凸成形术具有微创、安全、临床疗效良好的优点,是治疗骨质疏松性椎体压缩骨折理想方法之一。临床应用时,应注意严格掌握适应证、适当扩张球囊、灌注骨水泥等技术要点,以避免严重并发症的发生。

Application of Percutaneous Kyphosplasty in the Treatment of Osteoporotic Vertebral Body Compression Fractures

Objective To assess the efficacy of hyperextension reduction with percutaneous kyphosplasty （PKP） in the treatment of osteoporotic vertebral compression fractures （OVCF）. Methods 43 vertebral osteoporotic vertebral compression fractures in 25 patients were treated with percutaneous kyphosplasty by injected Polymethylmethacrylate （PMMA） under Carm shape fluoroscopy monitoring. The data of the vertebral heights and Cobb angle were analyzed before and post operation. Results All patients tolerated the procedure well. No neurological symptomatic and other severe complications were found in all patients. The patients were followed up for 6-12 months （9 months on average）, X-ray examination showed that the height of vertebral body was maintained, Cobb angle improved significantly. Conclusion The hyperextension reduction with PKP is a recommendable method for OVCF. It is a mini-invasive operation,satisfying therapeutic effect good functional recovery, as well as obvious relief of pain.