后路减压截骨术治疗有神经症状的骨质疏松性椎体骨折塌陷

目的观察后路减压截骨术治疗有神经症状的骨质疏松性椎体骨折塌陷的疗效及安全性。方法对2004年1月～2008年6月收治的20例有神经症状的骨质疏松性椎体骨折塌陷患者采用后路减压截骨术治疗。使用疼痛视觉模拟评分（visual analogue scale,VAS）评估疼痛改善情况,Oswestry功能障碍指数（Oswestry disability index,ODI）评估功能改善情况,Frankel分级法评估神经功能状态,通过X线片测量Cobb角评估畸形及固定、融合情况,记录手术并发症。结果所有患者随访14～30个月,平均23个月,无严重并发症发生。术后2周VAS评分及ODI较术前明显改善（P〈0.05）;术后塌陷椎体局部Cobb角与术前相比明显改善;所有患者均未发生内固定相关并发症。术后1年神经功能Frankel分级较前改善。结论后路减压截骨术是治疗有神经症状的骨质疏松性椎体骨折塌陷的有效疗法,其安全性较高。

Posterior spinal decompression and osteotomy for osteoporotic vertebral fracture and collapse with neurological complication

Objective To evaluate the efficacy and safety of posterior decompression and osteotomy for osteoporotic vertebral fracture and collapse with neurological complication. Methods From January 2004 to June 2008, 20 patients who were diagnosed as osteoporotic vertebral fracture and collapse with neurological complication underwent posterior decompression and osteotomy.The clinical and radiological data were reviewed retrospectively. The clinical results were evaluated by the visual analogue scale (VAS) and Oswestry disability index (ODI). The neurological function was judged by Frankel classification. Cobb's angle was measured on preoperative and postoperative roentgenographs to evaluate the condition of deformity, fixation and fusion. The complications were also recorded. Results All the patients were followed up for 14-30 months, with a mean time of 23 months. No severe surgical complication was occurred. The VAS and ODI at postoperative 2 weeks were significantly improved compared with the preoperative data (P<0.05). The Cobb's angle of the collapse vertebrae were significantly corrected compared with the preoperative data. There were no complication related to the internal fixation failure occurred. At the postoperative 1 year follow-up, the neurological function were improved. Conclusion For osteoporotic vertebral fracture and collapse with neurological complication, the posterior decompression and osteotomy are effective and safe.