椎体支架系统经皮椎体后凸成形术结合唑来膦酸治疗重度骨质疏松性椎体骨折

目的:探讨椎体支架(vertebral body stents,VBS)系统经皮椎体后凸成形术(percutanous kyphoplasty,PKP结合唑来膦酸治疗重度骨质疏松性椎体骨折的临床疗效。方法:回顾性分析2017年12月至2018年12月收治的48例骨质疏松性胸腰椎骨折,其中男13例,女35例,年龄55～92(71.2±10.5)岁,全部采用VBS系统PKP手术方案,术后联合使用唑来膦酸注射液抗骨质疏松治疗,比较术前、术后3 d及半年的疼痛视觉模拟评分(visual analogue scale,VAS),Oswestry功能障碍指数(Oswestry Disability Index,ODI),病椎丢失高度,并观察术后有无病椎或邻椎再骨折情况。结果:术前VAS评分为7.60±0.12,术后3 d为3.00±0.46,术后半年为1.20±0.23,术后VAS评分明显改善(P<0.05),术后3 d与术后半年比较差异无统计学意义(P>0.05)。术前ODI指数为(82.00±0.32)%,术后3 d为(30.00±1.50)%,术后半年为(18.00±0.16)%...

Treatment of severely osteoporotic vertebral compression fractures with the vertebral body stent system and percutanous kyphoplasty combined with zoledronic acid

Objective: To investigate the clinical efficacy of vertebral body stent (VBS) system and percutanous kyphoplasty (PKP) combined with zoledronic acid for the treatment of severely osteoporotic compression vertebral fractures (OVCFs).Methods: The clinical data of 48 patients with osteoporotic thoracolumbar fractures treated from December 2017 to December 2018 were retrospectively analyzed,including 13 males and 35 females,aged 55 to 92 years old with an average (71.2±10.5) years. All patients were treated with VBS system PKP surgery,and zoledronic acid injection was used for anti-osteoporosis treatment after operation. The VAS scores ODI,the height of diseased vertebral lost were compared before operation,3 d and half a year after operation,and whether there was re-fracture of diseased or adjacent vertevrae after operation was observed.Results: Before operation,3 d and half a year after operation,VAS scores were 7.60±0.12,3.00±0.46,1.20±0.23,ODI were (82.00±0.32)%, (30.00±1.50)%, (18.00±0.16)%,the height of diseased vertebral lost were (12.00±0.43) mm, (3.00±0.15) mm, (3.60±0.51) mm respectively. Postoperative VAS score,ODI,the height of diseased vertebral lost were obviously improved (P<0.05),and there was no significant difference between 3 d and half a year after operation (P>0.05). All the 48 patients were followed up with an average time of (6.6±0.5) months. All the incisions healed at grade A after operation,and no re-fracture of diseased vertebrae or adjacent vertebrae was found at the final follow-up.Conclusion: VBS system and PKP combined with zoledronic acid in the treatment of OVCFs not only may effectively relieve the pain in the thoracolumbar back,improve the mobility of the thoracolumbar,but also can restore the height of the vertebral body to the maximum extent,and prevent the re-fracture of the affected vertebrae and adjacent vertebrae,which is worthy to spread in clinic.