微创治疗胸腰椎压缩性骨折的疗效分析  

Analysis of therapeutic effects of minimal invasive therapy for thoracic/lumbar vertebral compression fracture

作　　者：管宏新[1] 朱晋[1] 仲骏[1] 万亮[1] 周秋梦[1] 尚明[1] 杨敏[1] 

机构地区：[1]上海交通大学医学院附属新华医院神经外科,上海200092

出　　处：《上海交通大学学报（医学版）》2010年第10期1258-1262,共5页Journal of Shanghai Jiao tong University:Medical Science

摘　　要：目的观察经皮椎体成形术(PVP)和经皮椎体后凸成形术(PKP)治疗胸腰椎压缩性骨折的临床疗效。方法 PVP或PKP微创治疗胸腰椎压缩性骨折20例(28椎);术前、术后24 h及出院后随访时进行疼痛视觉模拟评分(VAS);术前及出院后随访时进行Oswestry功能障碍指数(ODI)评分;分析术后24 h及随访时患者满意度。结果 20例手术均顺利完成,其中采用PVP 4例(5椎),PKP 16例(23椎);无严重并发症发生;获随访1～24个月,平均8个月。患者术前VAS为(8.9±0.4)分,术后24 h为(2.1±2.0)分,最后随访时为(2.2±1.9)分;术后24 h及最后随访时VAS较术前比较,差异有统计学意义(P<0.05)。最后随访时ODI明显低于术前(P<0.05),分别为(25.8±10.4)%和(56.4±10.8)%。患者术后24 h的满意率为95.0%,最后随访时为89.5%。结论 PVP/PKP治疗胸腰椎压缩性骨折,创伤小,可达到满意的止痛效果,还可预防椎体再塌陷、增强活动能力、提高患者生活质量,是一种安全有效的方法。Objective To analysis therapeutic effects of percutaneous vertebroplasty（PVP） and percutaneous kyphoplasty（PKP） on treating thoracic/lumbar vertebral compression fracture. Methods Twenty patients（28 vertebrae） suffered from thoracic/lumbar vertebral compression fracture were treated by minimal invasive therapy,PVP and PKP.Visual analog scale（VAS） of patients was measured before operation,24 h after operation,and during follow-up.Oswestry disability index（ODI） of patients was measured before operation and during follow-up.Patients were investigated retrospectively of their satisfaction toward surgery 24 h after operation and during follow-up. Results All 20 patients received successful operation without any complication.Four patients underwent PVP（5 vertebrae） and 16 received PKP（23 vertebrae）.All patients were followed up from 1 to 24 months（mean 8 months）.The VAS was 8.9±0.4,2.1±2.0,and 2.2±1.9 before operation,24 h after operation,and at the last follow-up,respectively.Compared with preoperative scale,there was significant differences to the other two scales（P0.05）.The ODI of the last follow-up [（25.8±10.4）%] was significantly lower than ODI of before operation [（56.4±10.8）%]（P0.05）.The satisfaction rates were 95.0% 24 h after operation and 89.5% at the last follow-up,respectively. Conclusion PVP or PKP has minimal invasion with remarkable antalgic effects in treating vertebral compression fracture,which prevents vertebral collapse and improves body activity and quality of life.The operation is a safe and effective therapy.

关 键 词：经皮椎体成形术 经皮椎体后凸成形术 胸腰椎压缩性骨折 微创手术 

分 类 号：R687.3[医药卫生—骨科学]