单侧穿刺经皮椎体注入骨水泥后凸成形治疗多椎体骨质疏松性压缩骨折  

Unilateral percutaneous kyphoplasty for the treatment of osteoporotic thoracolumbar multi-vertebral compressive fractures

作　　者：徐俊杰[1] 李业海[1] 唐浩然[1] 梁俊升[1] 董利军[2] 王强[2] 

机构地区：[1]巢湖市第一人民医院骨二科,安徽省巢湖市238001 [2]皖南医学院附属弋矶山医院骨一科,安徽省芜湖市241000

出　　处：《中国组织工程研究与临床康复》2010年第25期4661-4664,共4页Journal of Clinical Rehabilitative Tissue Engineering Research

摘　　要：背景:经皮椎体成形和经皮椎体后凸成形是一种治疗骨质疏松症所致椎体压缩性骨折的新方法,目前已经在各大医院广泛开展,但是在临床上很多病例有多个椎体的骨折,采用经典的手术方法操作次数多,增加手术风险,射线暴露量大,医疗费用高。目的:观察单侧穿刺经皮椎体后凸成形治疗老年多椎体骨质疏松压缩骨折的疗效。方法:选择2007-06/2009-06巢湖市第一人民医院骨二科和皖南医学院附属弋矶山医院骨一科收治的多椎体骨质疏松压缩骨折患者12例(29椎),根据治疗前MRI信号改变判断疼痛性椎体并进行选择性单侧穿刺球囊扩张后凸成形的治疗。根据目测类比评分评价手术前后疼痛变化,观察治疗后症状改善、骨折复位情况及有无并发症发生。结果与结论:12例穿刺均顺利完成,48h内疼痛缓解,平均随访14个月。治疗后目测类比评分较治疗前降低(P<0.01)。椎体前缘、中部、后缘平均高度治疗前低于治疗后,至末次随访椎体复位后前缘、中部、后缘平均高度未见明显丢失(P>0.05)。治疗前穿刺侧与对侧椎体高度差距有显著性意义(P<0.01),治疗后两侧差距无显著性意义(P>0.05)。治疗前后同侧相比差异均有显著性意义(P<0.01)。提示对多椎体压缩骨折采用选择性单侧穿刺后凸成形治疗,临床效果满意,能够缩短治疗时间、减少并发症、射线暴露和治疗费用,适于老年多椎体骨质疏松压缩骨折的治疗。BACKGROUND：Percutaneous vertebroplasty and percutaneous kyphoplasty are new methods for treatment of osteoporosis-caused vertebral compression fractures,they have been widely used in hospitals,but in many cases with multiple vertebral fractures,frequent classical surgeries may increase the risk of surgery,radiation exposure,and medical costs.OBJECTIVE：To explore the therapeutic effect of unilateral percutaneous kyphoplasty for the treatment of osteoporotic thoracolumbar multi-vertebral compressive fractures in aged patients.METHODS：Twelve patients（29 vertebral bodies） of osteoporotic thoracolumbar multi-vertebral compressive fractures were treated from June 2007 to June 2009 at the Second Department of Orthopaedics in the First Hospital of Chaohu City and at the First Department of Orthopaedics in Yijishan Hospital,Wannan Medical College.The painful vertebral bodies were determined according to MRI signal before operation,and were treated by selective unilateral paracentesis kyphoplasty.The pains before and after operation were assayed using visual analogous scale.The improvement,reduction of fracture and any complication happened were observed.RESULTS AND CONCLUSION：All 12 patients completed paracentesis with immediate relief of their back pain within 48 hours.Visual analogous scale score was reduced compared with preoperative score（P 0.01）.The preoperative mean height of the anterior,media and posterior vertebral bodies were lower than postoperative height.At the latest follow-up,the mean height of the anterior,media and posterior vertebral bodies was not markedly reduced compared with postoperative（P 0.05）.There were significant differences in the mean height between paracentesis side and opposite side before operation（P 0.01）,no significant difference after operation（P 0.05）.Before and after operation,the same side exhibited significant differences（P 0.001）.For the treatment of osteoporotic thoracolumbar multi-vertebral compressive fractures,unilateral percutaneous kyphoplasty

关 键 词：骨质疏松 脊柱 压缩骨折 后凸成形 骨水泥 

分 类 号：R318[医药卫生—生物医学工程]