椎体成形术与椎体后凸成形术治疗胸腰椎压缩骨折

目的评估经皮椎体成形术（percutaneous vertebroplasty,PVP）和经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）治疗骨质疏松性椎体压缩骨折的临床效果。方法回顾性分析2003年6月至2008年6月间采用了PVP和PKP治疗的53例骨质疏松性胸腰椎压缩性骨折,于术前、术后3 d和术后3个月随访时进行疼痛强度评价的视觉模拟评分（visual analogue scale,VAS）及术前、术后3 d和术后3个月椎体前缘高度压缩变化测量。结果 53例患者手术操作全部成功,1例出现骨水泥渗透到椎体旁。疼痛完全缓解32例（60.4%）,显著缓解21例（39.6%）。术后及随访6个月,VAS评分、椎体压缩率与术前比较有显著性差异（P〈0.05）。长期随访观察疼痛无复发,X线片未见椎体高度丢失。结论 PVP及PKP治疗胸腰椎骨质疏松性椎体压缩骨折具有微创、安全、疗效优良、并发症少的优点,是治疗老年椎体压缩骨折的理想方法。合适的手术适应证选择和良好的术中操作是防止并发症的关键。

Clinical Study of Percutaneous Vertebroplasty and Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fracture of Thoracolumbar Spine

Objective To explore the clinical outcome of the percutaneous vertebroplasty（PVP）and percutaneous kyphoplasty（PKP）in the treatment of osteoporotic vertebral compression fracture（OVCF）in thoracolumbar spine.Methods The date of Fifty-three patients of thoracolumbar OVCF undergone PVP or PKP from Jun.2003 to Jun.2008 were gathered for this retrospective study.the visual analog scales（VAS）was used to assess pain severity before and after 3 days and 6 months,and the recover of anterior height of vertebrae body was used for radiographic assessments before and after at the 3 days and 6 months.Results All patients came through a desirable puncture and showed no clinical sympotom except for 1 case complicated with bone cement leakage into vertebral lateral.32 patients obtained total relief（60.4%）,21 patients obtained significant relief（39.6%）.Statistic analysis showed that preoperative VAS,the recover of anterior height of vertebrae body and ease of pain ODS had remarkable difference with those postoperatively and during the 6 month long follow up.Follow up found no recurrence of the symptoms,X-ray and CT films showed no loss of the vertebral height.Conclusion PVP and PKP can quickly relieve pain and enhance vertebral stability in treating thoraco-lumbar OVCF.