经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折

目的:探讨经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效。方法:采用经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折患者40例45个椎体,观察手术前后疼痛视觉模拟评分、椎体高度及Cobb角的改变。结果:所有患者均顺利通过手术。术后疼痛明显缓解,VAS评分由术前(7.55±1.32)分降至术后(2.15±1.27)分;骨折椎体前缘、中部高度由术前(17.11±2.07)mm和(14.6±1.32)mm增加至术后(21.34±1.53)mm和(18.7±2.04)mm;Cobb角由术前23.2°±4.6°降至术后14.1°±3.5;°差异均有统计学意义(P0.05)。3例患者骨水泥从椎体上终板渗漏,未出现临床症状。36例患者获得随访,随访时间3～24个月,平均8.3月,腰背部疼痛明显缓解或消失,未出现与手术相关的并发症。结论:经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折,能够迅速缓解疼痛,恢复脊柱的形态,是一种既有效又安全的微创治疗方法。

Clinical observation on the curative effect of percutaneous kyphoplasty on the treatment of osteoporotic vertebral compression fracture in the aged

Objective：To explore the clinical curative effect of percutaneous kyphoplasty（PKP）on the treatment of osteoporotic vertebral compression fracture（OVCF）in the aged.Methods：40 OVCF senile patients with 45 vertebral body were treated by PKP.The changes of visual analogue scale of pain（VAS）,vertebrae height and Cobb angle were observed before and after the operation.Results：Operations were carried out successfulfy for all the patients.Patients′ pain were relieved obviously after the operation,and VAS decreased from preoperative（7.55±1.32）points to postoperative（2.15±1.27） points.Anterior height and central height of fractured vertebral body increased from preoperative（17.11±2.07）mm and（14.6±1.32）mm to postoperative（21.34±1.53）mm and（18.7±2.04）mm respectively.Cobb angles decreased from preoperative（23.2°±4.6°） to postoperative（14.1°±3.5°）.There was statistical difference between preoperative data and postoperative data（P〈0.05）.Leakage of bone cement from vertebral upper endplate was found in 3 cases,but no clinical symptoms were displayed.36 cases were followed up from 3 to 24 months with an average of 8.3 months,lumbodorsal pain of them was obviously relieved or disappeared,and no complications related to operation were found among them.Conclusion：Percutaneous kyphoplasty can rapidly relieve the pain and recover spinal morphous,and it is a kind of effective and safe minimally invasive treatment of osteoporotic vertebral compression fracture in the aged.