骨质疏松性椎体压缩骨折的经皮椎体成形术

目的评估经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床应用及疗效。方法本组22例（48个椎体）骨质疏松性椎体压缩骨折患者（脊椎骨折部位为Tq～L5）在单C臂DSA机透视引导下于俯卧位行经皮穿刺椎体成形术，注射聚甲基丙烯酸甲酯骨水泥。在术前、术后3d、随访期进行疼痛视觉模拟评分和活动能力评分。随访时间3～20个月。结果22例48个椎体手术操作全部成功。骨水泥注射量1．5～4．0mL／椎体。患者术后4～24h开始疼痛症状明显减轻。VAS术前（7．2±1．1），术后3d（2．5±1．0）较术前显著下降（P〈0．001）；随访时为（2．2±1．0），比术后3d又略有下降。活动能力评分术后3d（1．5±0．4）较术前（2．5±0．7）明显改善（P〈0．001）；随访时为（1．4±0．5），行动能力较术后3d无明显变化。结论经皮椎体成形术是治疗症状性骨质疏松椎体压缩骨折的一项安全、有效、微创的医学技术。

Percutaneous Vertebroplasty for Osteoporotic Vertebral Compression Fractures

Objective To evaluate the clinical application and therapeutic effect of percutaneous vertebroplasty （PVP） in treating symptomatic osteoporotic vertebral compression fractures. Methods Twenty-two patients with osteoporotic vertebral compression fractures were treated by percutaneous vertebroplasty （PVP）. The fracture segment was within T9-L5. Under the guidance of single-plane C-arm fluoroscopy, bone marrow harvest needle was inserted percutaneously into the fractured vertebrae by the transpedicular approach. Polymethylmethacrylate （PMMA） mixture was then injected into the fractured vertebrae. Visual analogue scale （VAS） and mobility were evaluated before and 3 days after the procedure and in the follow-up period, The average follow-up period was 8 months （3-20 months）. Results PVP was technically successful in all the patients（48 vertebrae）. The average volume of PMMA cement injected was 2.7mL （range,1.5-4.0mL）. The analgesic effect ocurred within 4-24 hours after the procedure. VAS was sharply decreased from pre-PVP（7.2 ± 1.1） to （2.5 ± 1.0） at day 3 after PVP（P〈0.001）. It decreased slightly to （2.2 ± 1.0） during the follow-up period. Scale of patient＇s mobility was increased from pre-PVP （2.5±0.7） to （1.5±0.4） at day 3 after PVP with a significant difference （P〈 0.001 ）. It was （1.4 ± 0.5） during the follow-up period and without significant difference compared with post PVP. Conclusion PVP is a safe, effective and mini-invasive technique for symptomatic osteoporotic vertebral compression fractures.