球囊扩张椎体后凸成形术治疗骨质疏松性椎体骨折骨不愈合  

Treatment of nonunion of osteoporotic vertebral fractures by balloon kyphoplasty

作　　者：杨惠林[1] 王根林[1] 牛国旗[1] 周军 孟斌[1] 唐天驷[1] 

机构地区：[1]苏州大学附属第一医院骨科,215006

出　　处：《中华创伤骨科杂志》2007年第8期760-762,共3页Chinese Journal of Orthopaedic Trauma

基　　金：江苏省“135”重点学科基金资助项目（RC2003091）

摘　　要：目的探讨球囊扩张椎体后凸成形术治疗骨质疏松性椎体骨折骨不愈合的疗效。方法自2004年2月～2007年1月，对13例15个椎体发生骨不愈合的骨质疏松性椎体骨折患者行球囊扩张椎体后凸成形术治疗。术中采用经双侧椎弓根穿刺，置入2枚可扩张球囊使骨折塌陷椎体复位，灌注骨水泥充填由球囊扩张所形成的椎体内空腔。通过观察术后症状改善及骨折复位情况来评估其疗效。结果所有患者随访4～35个月，平均24．7个月。全部患者均顺利完成手术，无症状性并发症发生。术后疼痛即刻明显减轻或消失，l～2d后下地活动。术后椎体高度平均恢复率61．5％，后凸畸形Cobb角平均矫正8．5^o，术前与术后比较差异有统计学意义（t=8．987，P〈0．05）。疼痛视觉模拟评分由术前8．4分降至2．1分。结论球囊扩张椎体后凸成形术治疗骨质疏松性椎体骨折骨不愈合可有效缓解疼痛、改善功能及恢复脊柱序列，是治疗椎体骨不愈合的较好微刨方法之一。Objective To explore the clinical efficacy of balloon kyphoplasty in the treatment of nonunion of osteoporotic vertebral fractures. Methods From February 2004 to January 2007, balloon kyphoplasty was performed on 13 patients （15 vertebral bodies） with nonunion of osteoporotic vertebral compression fractures. Each procedure included bilateral insertion of inflatable balloon, fracture reduction and filling with bone cement. Preoperative and postoperative symptom levels, complications and radiographic findings were analyzed. Results All cases were followed up from 4 to 35 months （mean, 24. 7 months ）. All patients tolerated the procedure well with immediate relief of back pain after kyphoplasty. No symptomatic complications were found. The vertebral height had a recovery rate of 61.5%, and the mean Cobb angle was improved 8.5^o. There was a significant difference in Cobb angles between preoperation and postoperation （t = 8. 987, P 〈 0. 05） . Pain score by visual analog scale （VAS） reduced from 8.4 to 2.1. Conclusion As a promising mini-invasive surgery for nonunion of osteoporotic vertebral fractures, balloon kyphoplasty can relieve pain and improve function as well as spinal alignment.

关 键 词：脊柱骨折 骨质疏松 脊柱穿刺 骨不愈合 椎体后凸成形术 

分 类 号：R686[医药卫生—骨科学]