经皮椎体成形术治疗新鲜骨质疏松性椎体压缩骨折

目的探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗新鲜骨质疏松性椎体压缩骨折的疗效。方法 2011年1月~2012年12月共治疗骨质疏松性单椎体压缩骨折38例,其中男7例,女31例;年龄55~80岁(平均65.1岁)。患者取俯卧位局麻下行单侧穿刺PVP。测量椎体高度的恢复情况和后凸角改善情况,视觉模拟量表(visual analogue scale,VAS)评分评价疼痛缓解程度,活动能力评分检测活动改善情况,并对并发症进行分析。结果所有手术均顺利完成,每个椎体平均填充骨水泥3.5 m L。随访时间均12个月。椎体前壁高度由术前(19.2±5.7)mm改善至术后(20.0±5.7)mm,椎体中间高度由术前(19.2±5.1)mm改善至术后(20.2±5.0)mm,差异有统计学意义(P0.05);椎体后壁高度和Cobb角术前与术后相比,差异无统计学意义(P0.05);VAS评分术前8.3±1.1,术后12个月时为1.1±0.6,术前、术后差异有统计学意义(P0.05)。活动能力评分术前3.1±0.9,术后12个月时为1.1±0.3,术前、术后差异有统计学意义(P0.05)。骨水泥渗漏9例。结论 PVP可有效治疗新鲜骨质疏松性椎体压缩骨折,创伤小,减轻疼痛,改善功能,无重大并发症。

Percutaneous vertebroplasty for treatment of acute osteoporotic vertebral compression fractures

Objective To analyze the therapeutic effect of percutaneous vertebroplasty (PVP) for the treatment of acute osteoporotic vertebral compression fractures. Methods From January 2011 to December 2012, 38 cases were treated with PVP for one-level osteoporotic compression fracture, which included 7 males and 31 females in the age range of 55-80 years with a mean age of 65.1 years old. All operations were finished successfully under local anesthesia on the surgical area with 1% lidocaine at prone position. Body height and kyphotic Cobb's angle of vertebral bodies were measured before and after operation, pain levels and activity was evaluated by visual analogue scale(VAS) score and locomotor activity score at preoperative, postoperative 1 d, postoperative 1 week,postoperative 3 months and postoperative 12 months. Complications were also recorded. Results The average operation time was 32 min(ranging 25-50 min). An average of 3.5 mL Polymethylmethacrylate(PMMA)were injected. Follow-up period was more than 12 months. Respective preoperative and postoperative, the anterior height of the vertebral body were (19.2±5.7) mm and (20.0±5.7) mm; the medium height of the vertebral body were (19.2±5.1)mm and (20.2±5.0) mm; the difference was statistically significant(P< 0.05). There was no difference in the posterior vertebral height and the kyphotic Cobb's angle correction rate at preoperative and postoperative. Pain relief and mobility improvement were observed after the operation. VAS score revealed a decrease from 8.3±1.1 to 1.1±0.6. Locomotor activity score decreased from 3.1±0.9 to 1.1±0.3. Cement leakage happened in 9 patients without neurological complications. Conclusion PVP can achieve satisfactory clinical outcomes in treating acute osteoporotic compression fractures.