经皮椎体后凸成形术在治疗多节段骨质疏松性椎体压缩骨折的应用

目的探讨经皮椎体后凸成形术治疗多节段骨质疏松性椎体压缩性骨折的疗效。方法对47例多节段骨质疏松性椎体压缩性骨折患者共104个伤椎实施经皮椎体后凸成形术。根据手术前后伤椎的椎体矢状面指数(VSI)、后凸Cobb角,评价椎体解剖形态的恢复情况。比较术前与术后1周、术后1年的模拟视觉类比评分(VAS)和功能障碍指数(ODI),评价疼痛缓解情况和脊柱功能恢复情况。结果患者均获得随访,时间12～24(17.3±2.7)个月。术前与术后1周、术后1年VSI分别为0.63±0.31、0.94±0.12和0.92±0.32,术后1周、术后1年与术前比较,差异有统计学意义(P<0.01);后凸Cobb角分别为39.12°±5.53°、8.24°±4.11°和8.66°±6.57°,术后1周、术后1年与术前比较差异有统计学意义(P<0.01);VAS分别为9.26分±0.60分、1.79分±1.21分和1.90分±0.86分,术后1周、术后1年与术前比较,差异有统计学意义(P<0.01)。ODI分别为82.71分±3.67分、19.50分±2.73分和24.14分±4.10分,术后1周、术后1年与术前比较,差异有统计学意义(F=261.32,P<0.01)。结论经皮椎体后凸成形术治疗多节段骨质疏松椎体压缩性骨折创伤小,能较好地恢复伤椎高度,矫正后凸Cobb角,止痛效果和脊椎功能恢复均满意。

Percutaneous kyphoplasty in treatment of multi-level osteoporotic vertebral compression fractures

Objective To explore the surgical curative efficacy of percutaneous kyphoplasty(PKP)on the treatment of multi-level osteoporotic vertebral compression fractures(OVCFs).Methods PKP were performed in 47 patients(104 injured vertebrae) with multi-level OVCFs.The vertebral sagittal index(VSI)and Cobb′s angle of the injured vertebrae were measured to evaluate the recovery of vertebral anatomy with the X-ray pre-,or post-operatively.Visual analogue scale(VAS)and oswestry disability index(ODI)were calculated to evaluate the release of pain and the recovery of spinal function pre-operatively and on 1 week,1 year postoperatively.Results All patients were followed up for an average of 17.3 months(ranged from 12 to 24 months).VSI was 0.63±0.31 pre-operatively,0.94±0.12 one week post-operatively and 0.92±0.32 one year post-operatively.The difference of VSI in pre-operative group was statistically significant compared to 1 week post-operative group or 1 year post-operative group(P<0.01);The Cobb′s angle was 39.12±5.53 degree pre-operatively,8.24±4.11 degree one week post-operatively and 8.66±6.57 degree one year post-operatively.The difference of Cobb′s angle in pre-operative group was statistically significant compared to 1 week post-operative group or 1 year post-operative group(P<0.01);The VAS score was 9.26±0.60 pre-operatively and 1.79±1.21 one week post-operatively,1.90±0.86 one year post-operatively.There was significant difference between pre-operative group and 1 week post-operative group or 1 year post-operative group(P<0.01).The ODI score was 82.71±3.67 pre-operatively and 19.50±2.73 one week post-operatively,24.14±4.10 one year post-operatively.There was significant difference between pre-operative group and 1 week post-operative group or 1 year post-operative group(F=261.32,P<0.01).Conclusions It is minimal invasive by using PKP for the treatment of multi-level OVCFs.Satisfied recovery can be expected in vertebral height,Cobb′s angle,relief of the pain and restoration of spinal functional.