经皮椎体成形术和后凸成形术在多节段椎体骨折中的应用

目的探讨经皮椎体成形术（PVP）和后凸成形术（PKP）治疗多节段骨质疏松性椎体压缩骨折的安全性及疗效。方法PVP和PKP治疗21例多节段骨质疏松性椎体压缩骨折患者共69节胸腰椎。分析患者术前、术中、术后的临床及影像学资料,采用模拟视觉评分（VAS）及Oswesty功能障碍指数（ODI）评价术前、术后疼痛缓解及日常活动功能恢复情况。结果19例一次手术完成3节椎体,2例一次手术完成6节椎体。1例术中出现一过性血压降低和呛咳。VAS评分术前为（8.75±1.32）分,术后1 d为（2.47±1.26）分,术后6个月为（2.03±1.98）分;OD I值术前为83.12±11.24,术后1 d为27.12±9.43,术后6个月为29.04±10.13,疼痛缓解及日常活动功能恢复明显。结论PVP和PKP是治疗多节段骨质疏松性椎体压缩骨折安全、有效的方法。必须注意术中生命体征的变化,一次手术最多完成3-4节椎体。

Percutaneous vertebroplasty and balloon kyphoplasty: applications in multi-level vertebral compression fractures

Objective To investigate the clinical efficiency and safety of percutaneous vertebroplasty and kyphoplasty for patients with multi-level osteoporotic vertebral compression fractures.Methods Twenty-one cases of multi-level osteoporotic vertebral compression fractures including 69 sections were reviewed.The outcome was evaluated carefully by pre-and post-operatively the Visual Analogue Scale（VAS） for pain relief,the Oswestry Disability Index（ODI）for the improvement activity of daily life respectively.Results All procedures were performed successfully.19 patients have received 3 procedures in one session,6 sections in one session were operated in two patients respectively.1 patients had a transient low blood pressure,cough and dyspnea and recovered shortly.The VAS and ODI improved from a mean preoperative score of 8.75±1.32 and 83.12±11.24 to a mean postoperative score of 2.47±1.26 and 27.12±9.43 the first day after operation or 2.03±1.98 and 29.04±10.13 six months afterward respectively Conclusions Vertebroplasty and kyphoplasty to treat multi-level osteoporotic vertebral compression fractures in the elderly is safe and effective,providing immediate and long-term pain relief with improvement in quality of life.The limitation of three to four sections per session must be kept strictly.