经皮球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩性骨折近期疗效分析  

Short-term Curative Effect of Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures

作　　者：吴承钧[1] 童培建[2] 厉驹[2] 季卫锋[2] 曹靓[1] 沈国华[1] 骆峪潇[1] 张善星[1] 

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江省中医院骨伤科

出　　处：《中国中医骨伤科杂志》2011年第2期10-12,15,共4页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：浙江省卫生厅科研项目2006A085

摘　　要：目的:观察经皮球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩性骨折近期疗效。方法:2005年1月～2010年3月在本科进行骨质疏松性椎体压缩性骨折患者行经皮球囊扩张椎体后凸成形术治疗的299例患者。术前通过完善检查结合体征及X线、MRI等影像学检查明确诊断。经皮球囊扩张椎体后凸成形术在C臂机的监视下完成,行双侧椎弓根穿刺,分别置入球囊,扩张椎体后注射骨水泥,随访6个月,观察后凸畸形、病椎高度、手术前后疼痛程度及活动能力的变化。结果:299例患者总有效率95.7%。本组术前平均疼痛得分是(8.5±1.3)分,术后24h平均得分降低到(2.2±1.2)分(P<0.01)。本组术前平均活动能力得分是(3.6±1.0)分,术后24 h平均得分降低到(1.6±0.9)分(P<0.05)。术后24 h X线检查压缩骨折的椎体高度恢复满意。术前病椎体前、中部的平均高度分别为原椎体高度的(56.22±10.51)%和(63.36±10.13)%,术后明显改善恢复到(87.16±12.35)%和(85.27±14.32)%(P<0.05)。胸腰段脊柱后凸畸形Cobb’s角由术前的(19.2±8.1)°矫正至术后的(12.7±6.7)°(P<0.05)。结论:PKP治疗椎体压缩性骨折安全有效,具有创伤小、恢复快、并发症少等特点,能有效缓解疼痛,恢复椎体高度和强度,改善骨量丢失情况,进一步的改进该项技术以减少相关并发症可能是未来的研究方向。Objective：To assessment the short-term curative effect of percutaneous kyphoplasty（PKP） for treating osteoporotic vertebral compression fractures.Methods：From January 2005 to march 2010,299 patients with osteoporotic vertebral compression fractures were treated by PKP in our department.The diseases were confirmed through a physical examination,an X-ray,and magnetic resonance imaging before surgery.We established work path through hibateral vertebral arch,put into saccule,poured in bone cement under X-ray perspective.All the patients were follow-up for 6 months.The changes of kyphosis,vertebral height,pain,and motion ability were observed before and after surgery.Results：The total effective rate of PKP was 95.7% in our study.The average scores of VAS and motion ability were decreased from 8.5±1.3 and 3.6±1.0 before surgery to 2.2±1.2 and 1.6±0.9 one day after surgery respectively（P〈0.01,P〈0.05）.And the average vertebral heights of anterior and middle were increased from 56.22±10.51% and 63.36±10.13% before surgery to 87.16±12.35% and 85.27±14.32% after surgery respectively（P〈0.05）.The mean Cobb＇s angle of kyphosis were corrected from 19.2±8.1° to 12.7±6.7° after surgery（P 0.05）.Conclusion：The treatment of PKP is of great efficiency,safe,less trauma,fast recovery and few complications for osteoporotic vertebral compression fractures.And it can relieve the pain rapidly,increase the height and intensity of vertebrae,and decrease bone loss.To improve the PKP for reducing the complications may be the next research hotspot.

关 键 词：椎体压缩骨折 骨质疏松 经皮球囊扩张椎体后凸成形术 骨水泥 

分 类 号：R683.2[医药卫生—骨科学]