经皮椎体后凸注入骨水泥成形修复老年急性重度骨质疏松性压缩骨折62例

背景：经皮椎体后凸成形治疗老年急性重度骨质疏松性压缩骨折已成为国内外公认的有效方法,但是有关其疗效的文献所涉及的病例数较少。 目的：进一步验证应用经皮椎体后凸成形治疗老年急性重度骨质疏松性压缩骨折的临床效果。 方法：局麻下对62例老年急性重度骨质疏松性椎体压缩骨折共87个椎体行经皮椎体后凸成形治疗,单个椎体骨水泥注入量2.5~7.1 mL。随访均超过3个月,进行各项指标观察。 结果与结论：经皮椎体后凸成形后随访时伤椎前中柱椎体高度、疼痛目测类比评分较成形前显著改善(P < 0.01)。患者均无椎体后凸成形中、成形后死亡和脊髓神经脏器损伤情况发生。椎体前纵韧带后方渗漏2例,椎弓根内渗漏1例,于椎间隙渗漏1例;无感染、栓塞等并发症发生,椎体的高度平均恢复75%以上,所有患者椎体后凸成形后疼痛明显缓解,2例稍有腰痛,口服止痛药有效。末次随访椎体高度经X射线片检查与椎体后凸成形后比较无改变。证实局麻下经皮椎体后凸成形是治疗老年急性重度骨质疏松性压缩骨折的一种既安全又有效的方法。

Percutaneous kyphoplasty with bone cement repairs elderly acute severe osteoporotic compression fractures in 62 cases

BACKGROUND:Percutaneous kyphoplasty has become widely recognized as an effective method to treat elderly patients with acute severe osteoporotic compression fractures, but the number of cases involved in the relevant literature is less. OBJECTIVE:To explore the clinical effect of percutaneous balloon kyphoplasty on acute severe osteoporotic compression fractures in the elderly. METHODS:A total of 62 elderly patients with acute severe osteoporotic compression fractures (87 vertebrae) were treated with percutaneous balloon kyphoplasty, 2.5-7.1 mL bone cement for one vertebra. All the patients were followed up for over 3 months to observe changes in various indexes. RESULTS AND CONCLUSION:Patients receiving percutaneous balloon kyphoplasty had a significant improvement in the vertebral height and scores on visual analog scale (P < 0.01). No death or spinal cord/nerve injury occurred. Leakage of polymethyl methacrylate was found in two cases from anterior longitudinal ligament, one case from the vertebral arch, and one case from the intervertebral space. No infection and embolism happened, and the vertebral height recovered ≥75%. All patients had pain relief, including two cases of low back pain that relieved following oral administration of analgesic drug. Final follow-up results showed that the vertebral height had no changes. These findings indicate that percutaneous balloon kyphoplasty is safe and effective to treat acute severe osteoporotic compression fractures in the elederly.