经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折

目的探讨经皮球囊扩张椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折的疗效。方法45例(共99个椎体)骨质疏松性椎体压缩骨折患者行PKP治疗。所有手术均在C形臂X线机引导下进行。术前、术后及最终随访时分别进行视觉模拟疼痛评分、活动能力评分、使用止痛药物评分及Cobb角测量。结果所有手术均顺利完成,无严重手术并发症。视觉模拟评分(VAS)由术前的(7.8±1.1)分下降至术后的(2.3±0.8)分,最终随访时为(2.5±0.6)分。活动能力评分由术前的(3.3±0.5)分改善到术后的(1.2±0.3)分,最终随访时为(1.3±0.4)分。使用止痛药物评分由术前的(1.6±0.5)分下降至术后的(0.3±0.1)分,最终随访时为(0.4±0.2)分。Cobb角由术前的(30±5.3)°,矫正到术后的(21±3.6)°,最终随访时为(23±3.8)°。术后与术前、最终随访时与术前差别有显著性意义(P0.05);术后与最终随访时差别无显著性意义(P0.05)。结论经皮球囊扩张椎体后凸成形术是治疗骨质疏松性椎体压缩骨折的有效方法,创伤小,安全性好,能有效缓解疼痛,矫正后凸畸形。

Treatment of osteoporotic vertebral compressive fractures with percutaneous kyphoplasty

Objective To investigate the efficacy of percutaneous kyphoplasty in treating vertebral body com- pressive fractures in patients with osteoporosis. Methods Forty-five cases （99 vertebras ） of osteoporotic thoraco- lumbar compressive fractures were treated with percutaneous kyphoplasty. All operations were performed under the C-arm X-ray machine. The clinical effects were evaluated with visual analogue pain scale, the mobility scale, the pain-killer use scale and the Cobb＇s angle. Results All cases were successfully treated without serious postopera- tive complication. Visual analogue pain scale decreased from 7.8 ± 1.1 preoperatively to 2.3 ± 0.8 postoperatively, with the final score of 2.5 ± 0.6. Mobility scale improved from 3.3 ± 0.5 preoperatively to 1.2 ± 0.3 postoperative- ly,with the final score of 1.3 ± 0. 4. The pain-killer use scale decreased from 1.6 ± 0.5 preoperatively to 0.3 ± 0. 1 ,final score 0.4 ± 0.2. The Cobb＇s angle improved from 30 -± 5.3 ）°preoperatively to 21 ± 3.6 ） °postopera- tively,final score {23 ± 3.8）°. Pain relief and activity improvement were remarkable. There was significant differ- ence between post- and pre- operation, and between final follow-up and preoperation（ P 〈 0.05 ）. There was no sig- nificant difference between final follow-up and postoperation（ P 〉 0.05 ）. Conclusion Pereutaneous kyphoplasty is effective for osteoporotic vertebral compressive fractures ,which has advantages of minimal trauma and good security. It can relieve pain effectively and correct kyphosis.