经皮椎体后凸成形术治疗多发骨质疏松性椎体压缩性骨折的疗效分析

目的评估椎体后凸成形术（应用BMP-2磷酸钙骨水泥）治疗多发骨质疏松性椎体压缩性骨折的疗效及安全性。方法选取骨质疏松性椎体压缩性骨折患者共54例，在C型臂X线机引导下行椎体后凸成形术。分别在患者手术前后及随访时对疼痛、镇痛药使用、活动能力及影像学结果进行分析。结果所有手术顺利完成，椎体前缘高度由术前的（1．98±0．61）cm恢复到术后的（2．23±0．60）cm（P〈0．01），末次随访时为（2．23±0．53）cm；椎体中部高度由术前的（1．92±0．61）cm恢复到术后的（2．27±0．54）cm（P〈0．01），末次随访时为（2．26±0．60）cm；椎体后缘高度术前、术后及末次随访时无显着性差异（P〉0．05）。椎体后凸Cobb角亦得明显矫正，由术前的（24．32±12．37）°，改为术后的（21．85±11．02）°，与术前相比具有显着的统计学差异（P〈0．05），末次随访时为（22．77±12．01）°。术后随访平均20．4个月，术后6个月随访时疼痛症状较术前缓解或消失，VAS评分由术前的（8．20±1．14），下降至（2．70±1．24）（P〈0．01）；止痛药使用评分由术前的（1．59±0．91），下降到术后的（0．21±0．32）（P〈0．01），活动能力评分由术前的（2．91±0．75）提高到术后的（1．30±0．34）（P〈0．01），无严重临床并发症发生。结论椎体后凸成形术治疗骨质疏松性压缩性骨折方法简单，安全性高，可迅速缓解患者的疼痛，减少镇痛药依赖并改善生活质量。

Clinical Efficacy and Aafety of Percutaneous Kyphoplasty in Treatment of Aged Multiple Osteoporotic Vertebral Compression Fractures

Objective To evaluate the clinical efficacy and safety of percutaneous kyphoplasty（ BMP-2 and calcium phosphate cement） in the treatment of aged multiple osteoporotic vertebral compression factures. Methods Total 54 cases of aged multiple osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty under the guidance of C - typed X - ray unit. The pains, analgesic, activities and imaging features were compared preoperatively and postoperatively. Results All operations were smoothly finished. The anterior vertebral height was recovered from pre- operatively （ 1.98 ± 0. 61 ） cm to postoperatively （2.23 ± 0. 60） cm （ P 〈 0.01 ）. The anterior vertebral height was recovered for （2.23 ± 0. 53 ） cm at the last follow - up. The middle vertebral height was recovered from preoperatively （ 1.92 ±0. 61 ） cm to postoperatively（2.27 ±0. 54） cm （ P 〈0. 01 ）. The middle vertebral height was recovered for （2. 26 ± 0. 60） cm at the last follow - up. The posterior vertebral height were not significantly corrected preoperatively, postoperatively and the last follow up （ P 〉 0. 05）. The degree of the kyphosis （Cobb angles ） was recovered from preoperatively （24. 32 ± 12. 37°） to postoperatively（21.85 ± 11.02）°. The Cobb angles were significantly corrected preoperatively and postoperatively（ P 〈0. 05）. The Cobb angles were recovered for （22.77 ± 12. 01 ） ° at the last follow - up. The mean follow - up time was 20. 4 months. Pain has been disappeared or obviously relieved after 6 months. The VAS was recovered from preoperatively （ 8.20 ±1.14 ） to postoperatively （2. 70 ±1.24） （ P 〈0.01 ）. The analgesic was recovered from preoperatively （ 1.59 -＋0.91 ） to post- operatively（ 1.30 -＋0.34） （ P 〈0. 01 ）. There were no serious complications in all the cases. Conclusion This method of percutaneous kyphoplasty in the treatment of aged multiple osteoporotic vertebral compression fractures might be easy, si