单侧入路椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折临床研究

目的：探讨单侧入路椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的临床疗效和安全性。方法：将15例老年骨质疏松性胸腰椎压缩性骨折患者，行单侧入路穿刺椎体后凸成形术。记录手术时间和透视次数，观察术后患者背痛缓解程度及日常活动恢复情况，比较术前、术后伤椎高度和脊柱后凸畸形Cobb’S角。结果：15例患者均顺利完成手术，手术时间25～43min，平均28．6min；透视次数15～23次，平均19．8次；术后伤椎前部、中部高度，脊柱后凸畸形Cobb’S角与术前比较，差异有统计学意义（P〈0．05）；术后24h患者背痛均明显缓解，与术前比较差异有统计学意义（P〈0．05）。患者均能在术后次日下床行走，未发现神经损伤等手术并发症。结论：单侧入路穿刺球囊扩张椎体后凸成形术能有效地治疗老年骨质疏松性胸腰椎压缩性骨折，且操作简便、安全，能明显地减少患者和术者的放射暴露。

A clinical study of unilateral percutaneous balloon kyphoplasty for osteoporotic thoracolumbar compression fractures

Objective ：To evaluate the clinical efficacy and safety of unilateral percutaneous balloon kyphoplasty for osteoporotic thoracolumbar compression fractures. Methods： 15 patients of osteoporotic thoracolumbar compression fractures were operated on by unilateral percutaneous balloon kyphoplasty. The operative time and frequency of X-ray imagining were recorded. The degree of low back pain and recovery of daily activities of the paitents were observed. The Spinal kyphosis Cobb＇ s angle and height of vertebral body before kyphoplasty were compared with those after kyphoplasty. Results： All patients tolerated the procedure well with immediate relief of their back pain in 24 hours. The preoperative visual analogue scale（VAS） was significantly higher than postoperative VAS （P 〈 0.05 ）. The mean operative time was 28.6 min （25 - 43 min） and the mean frequency of fluoroscopy was 19.8 （ 15 - 23 ）. The patients were allowed to take walk next day after the procedure. Complications such as nerve damage was not demonstrated in the study. There were statistical difference in the Spinal kyphosis Cobb＇ s angle and height of vertebral body between preoperation and postoperation （ P 〈 0.05 ）. Conclusion ： Unilateral percutaneous balloon kyphoplasty is a safe and effective therapy for osteoporotic thoracolumbar compression fractures and the frequency of fluoroscopy and the amount of X-ray radiation decrease significantly.