经皮椎体成形术治疗陈旧性骨质疏松性椎体压缩骨折的临床观察

目的探讨经皮椎体成形术（percutaneous vertebroplasty，PVP）治疗陈旧性骨质疏松性椎体压缩骨折的临床疗效。方法回顾性分析56例（77个椎体）陈旧性骨质疏松性椎体压缩性骨折患者的临床资料，均行PVP术治疗。观察并比较手术前及术后3d、3月、6月、12月患者的疼痛VAS评分、日常生活能力恢复情况（ADL评分）及椎体高度恢复情况。结果本组56例患者共77节椎体均成功实施PVP手术，13例患者16节椎体（20．78％）发生骨水泥外漏，无截瘫、肺栓塞等严重并发症。与术前比较，术后3d、3月、6月、12月患者VAS评分均显著降低，ADL评分显著升高，且随时间延长，疼痛缓解程度和日常生活能力均逐步提高（P〈0．01）。与术前比较，术后3d、3月、6月、12月患者压缩椎体前缘及中间高度均明显恢复（P〈0．01）。结论PVP术治疗陈旧性骨质疏松性椎体压缩骨折具有明显缓解疼痛及恢复日常活动能力的效果，并可以部分恢复压缩椎体的高度，可以作为其首选治疗方法。

The Clinical Observation of Percutaneous Vertebroplasty for Old Osteoporotic Vertebral Compression Fractures

Objective To study the effect of percutaneous vertebroplasty （PVP） for the treatment of old osteoporotic vertebral compression fractures. Methods The clinical data of 56 patients （77 vertebras） with old osteoporotic vertebral compression fractures performed PVP were analyzed retrospectively. The visual ana- logue scale （VAS） , the activity of daily living scale （ADL） and the vertebral height were recorded and ana- lyzed before and after（3 day, 3 month, 6 month and 12 month） the operation. Results A total of 77 verte- bras in all 56 patients were successfully treated by PVP procedure. Bone cement leaking was found in 16 verte- bras of 13 cases. No complications such as paraplegia and pulmonary embolism were reported. Compared to preoperation, the VAS value were significant decreased and the ADL value were remarkable increased 3 day, 3-, 6- and 12 month after PVP, and the degree of pain relief and the ADL value were increased with the exten- sion of time （P 〈0.01 ）. The height of anterior and central border of the vertebral body were significant im- proved after the operation than those before the operation （ P 〈 0.01 ）. Conclusion PVP procedure is an ef- fective treatment for old osteoporotie compression fractures with advantages as remarkable pain relief, good re- covery of daily activity function and partial increase of the vertebral height, and it can be selected as a preferred method for old osteoporotic vertebral compression fractures.