经皮椎体成形术190例疗效评价

目的：通过大宗病例的统计分析，探讨X线透视下经皮椎体成形术治疗椎体骨质疏松性压缩骨折、椎体血管瘤、椎体转移癌的临床疗效。方法：2002年8月至2005年8月，采用C形臂X线机透视下俯卧位经皮椎弓根椎体穿刺190例（275个椎体，男80例，女110例；年龄53-91岁，平均66岁），注射PMMA。术前、术后3个月通过视觉模拟疼痛评分（VAS）、活动能力评分和止痛药使用评分的评定，比较改善情况。结果：190例275个椎体均手术成功，VAS术前平均（7．8±1．4）分，术后3个月平均（2．1±0．1）分，分数下降。活动能力评分：术后3个月平均（1．21±0.36）分。较术前平均（2．71±0．71）分明显改善。使用止痛药评分：术后3个月平均（0．89±0．43）分，较术前平均（2．12±0．56）分明显改善（P〈0．05）。结论：经皮椎体成形术为微创性手术，早期止痛效果好，术后下地时间早，避免了患者长期卧床引起的各种并发症，且手术操作简单、治疗费用低，是治疗椎体骨质疏松性压缩骨折、椎体血管瘤、椎体转移癌的有效方法。

Evaluation of percutaneous vertebroplasty of 190 cases

Objective: To evaluate the therapeutic effect of percutaneous vertebroplasty(PVP) guided by X-ray fluoroscopy in treating osteoporotic spinal compression fractures,hemangioma of vertebra and metastatic carcinoma of vertebra. Methods: One hundred and ninety patients with 275 diseased vertebra underwent PVP under the guidance of C-arm fluoroscopy(male 80,female 110,ranging in age from 53 to 91 years,with an average of 66 years). Bone marrow biopsy needle was inserted percutaneously via transpedicular way into the diseased vertebra. Polymethylmethacrylate(PMMA) was then injected into the diseased vertebra. Visual analogue scale(VAS),mobility and analgesic usage were evaluated pre-operation and 3 months after PVP. Results: PVP was successful in 190 cases(275 vertebrae).VAS was tested by t test at 3 months after PVP(P<0.05). Simultaneously,scale of patient's mobility and scale of analgesic usage was tested by rank sum test at 3 months after PVP(P<0.05). Conclusion: As the mimimally invasive operation,PVP can alleviate pain in early time,avoid kinds of complications by shortening the patient's time in bed and have the characteristic of simply operative procedure and low expenses. It is an effective mini-invasive technique for osteoporotic spinal compression fractures,hemangioma of vertebra and metastatic carcinoma of vertebra.