单侧经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折

目的探讨单侧椎弓根入路经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的近期临床疗效。方法 2009年7月至2010年12月,以单侧PKP对43例(49个椎体)骨质疏松性椎体压缩骨折的患者单侧行PKP治疗,随访期间进行模拟视觉评分(VAS)及日本矫形外科协会(JOA)评分,对其近期疗效和脊柱后凸角度的改善进行评估。结果与术前比较,患者术后腰背部疼痛明显缓解,术后VAS评分较术前明显降低(7.51±1.65vs1.93±1.55,P<0.01);手术24h后可离床活动,功能改善明显,JOA评分较术前明显增高(14.42±3.49vs22.58±3.46,P<0.01);X光片确认术后脊柱后凸成角显著减小(18.88°±8.36°vs6.58°±4.12°,P<0.01),提示后凸畸形得到有效纠正。在随访期内,除1例患者出现临近椎体压缩骨折,其余患者无其他并发症发生。结论单侧PKP治疗老年骨质疏松性椎体压缩骨折,症状缓解理想,脊柱后凸成角改善满意,具有良好的治疗效果。

Short-term clinical effect of unipedicular percutaneous kyphoplasty for the patients with osteoporotic vertebral compression fracture

Objective To study the short-term clinical outcome of unipedicular percutaneous kyphoplasty(PKP) for senile osteoporotic vertebral compression fracture. Methods A total of 43 patients (49 vertebrae)with osteoporotic vertebral compression fracture underwent unipedicular PKP from July 2009 to December 2010 were reviewed retrospectively.The pre-and post-operational visual analogue scales (VAS),The Japanese Orthopaedic Association(JOA)back pain scores and local vertebral Cobb′s angles of all cases were measured and evaluated. Results Compared with preoperation,the symptom of back pain in all patients was obviously decreased,the VAS score decreased significantly postoperation(7.51±1.65 vs 1.93±1.55,P<0.01). All patients could stand up and walk 24 hours after the operation, and the functions of spine and lower limbs were obviously improved,the JOA score increased significantly (14.42±3.49 vs 22.58±3.46,P<0.01).By X-ray,The vertebral Cobb’s angle after operation was significantly decreased (18.88°±8.36°vs 6.58°±4.12°,P<0.01),and this indicated that the deformation of spine kyphosis was effectively corrected.In the follow up period, adjacent vertebral compression fracture occurred in 1 case.No other complications were found. Conclusions Unipedicular PKP for senile osteoporotic vertebral compression fracture has a better efficacy:ideal remission of symptoms and satisfactory improvement of spine kyphosis.