椎体成形术在急性粉碎性椎体骨折中的临床应用

目的 评价经皮椎体成形术(PVP)治疗急性粉碎性椎体骨折的临床应用价值. 方法 对31例急性粉碎性椎体骨折患者38个病变椎体,在椎体骨折相对严重的一侧注入PMMA 2～6 ml.分别在术前、术后48 h记录VAS和巴塞尔指数以评价治疗效果. 结果 对31例患者共38个骨折的椎体进行PVP治疗.术前VAS评分为8.89±1.43,术后48 h为2.10±0.51,二者差异有统计学意义(P<0.001).巴塞尔指数术前为52.97±17.22,术后48 h为86.54±16.35,二者差异有统计学意义(P<0.001).其中9例在PMMA注射过程中进入椎体的两侧或前方,1例进入椎间盘和椎管,3例进入静脉,1例进入肺动脉,均未发现相关临床症状. 结论 PVP是治疗急性粉碎性椎体骨折的安全、有效的微创手术方法 .

Clinical application of percutaneous vertebroplasty in the treatment of acutely comminuted vertebral fractures

Objective To observe clinical value of percutaneous vertebroplasty (PVP) in the treatment of acute comminuted vertebral fractures. Methods Thirty-one patients with 38 acutely comminuted vertebral fractures underwent PVP. Polymethylmethacrylate (PMMA) was injected into the involved vertebrae through the relatively serious lateral. The injection dose of PMMA ranged from 2 ml to 6 ml. Both VAS and BI were evaluated before and 48 h after operation. Results The mean value of VAS was 8.89±1.43 before PVP, and 2.10±0.51 48 h after PVP (P<0.001). The mean value of BI was 52.97±17.22 before PVP, and 86.54±16.35 48 h after PVP (P<0.001). Perivertebral PMMA leakage was observed in 9 vertebrae, leaking to the adjacent disc and vertebral canal in 1 patient, to the venous plexus in 3 and pulmonary artery in 1 patient, but no corresponding clinical symptoms occurred. Conclusion PVP is a safe, effective and mini-invasive technique in the treatment of acute comminuted vertebral fractures.