椎体成形治疗伴椎体裂隙骨质疏松性椎体压缩骨折

背景：临床实践证明经皮椎体成形治疗骨质疏松性椎体压缩骨折有显著的疗效。目的：比较经皮椎体成形治疗伴或不伴椎体内裂隙样变骨质疏松性椎体压缩骨折的治疗效果，以确定椎体成形治疗椎体裂隙样变骨质疏松性椎体压缩骨折的有效性和安全性。方法：选择骨质疏松性椎体压缩骨折患者76例，分两组，实验组27例伴椎体内裂隙样变，对照组49例不伴椎体内裂隙样变。采用椎体成形治疗后，比较两组间目测类比评分和Oswesty功能障碍指数值、椎体前缘高度的变化，以及发生骨水泥外漏的类型和特点。结果与结论：两组治疗后的目测类比评分、Oswesty功能障碍指数值均明显低于治疗前(P < 0.05)，治疗后两组间目测类比评分、Oswesty功能障碍指数值及骨水泥外漏发生率比较差异无显著性意义(P > 0.05)。两组治疗后的伤椎高度与治疗前比较差异无显著性意义(P > 0.05)。说明椎体成形是减轻伴或不伴有椎体裂隙骨质疏松性椎体压缩骨折患者疼痛，改善脊柱活动功能及提高患者社会活动能力的有效方法，但不能有效恢复椎体高度。中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程全文链接：

Vertebroplasty for treatment of osteoporotic vertebral compression fractures with intravertebral cleft

BACKGROUND: Clinical practice verified that percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures obtained obvious curative effects. OBJECTIVE: To compare the therapeutic effect of percutaneous vertebroplasty for treatment for osteoporotic vertebral compression fractures with or without intravertebral cleft, in order to evaluate the efficacy and safety of percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures.  METHODS: A total of 76 patients with osteoporotic vertebral compression fractures were selected and divided into two groups. Experimental group consisted of 27 patients with intravertebral cleft. Control group comprised 49 patients without intravertebral cleft. After vertebroplasty, visual analogue scale and Oswestry disability index, changes of anterior vertebral height, and types and characteristics of bone cement leakage were compared between the two groups. RESULTS AND CONCLUSION: Visual analogue scale and Oswestry disability index were significantly decreased after treatment in the two groups (P < 0.05). No significant differences in visual analogue scale, Oswestry disability index and incidence of bone cement leakage were detected between the two groups after treatment (P > 0.05). No significant difference in the height of injured vertebra was detectable between pretreatment and posttreatment in the two groups (P > 0.05). These results suggested that vertebroplasty is an effective method for lessening the pain in osteoporotic vertebral compression fractures in patients with or without intravertebral cleft, improving spinal activity function and elevating social activities. However, percutaneous vertebroplasty cannot effectively recover the height of the vertebra.