经皮椎体后凸成形术治疗骨质疏松性胸腰椎骨折  

Percutaneous kyphoplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures

作　　者：王锡三[1] 王敏[1] 刘赫[1] 刘诚[1] 胡广询[1] 刘东宁[1] 

机构地区：[1]广东医学院附属南山医院骨二科,深圳518052

出　　处：《中华内分泌外科杂志》2012年第3期188-191,共4页Chinese Journal of Endocrine Surgery

摘　　要：目的探讨经皮椎体后凸成形术（PKP）治疗胸腰椎骨折的方法及疗效。方法回顾性分析2004年1月至2011年11月广东医学院附属南山医院收治的胸腰椎骨质疏松性椎体压缩性骨折患者96例共110个椎体，均采用经椎弓根单侧PKP或合并另外一侧椎体成形术（PVP）的方法进行治疗，并对其术后椎体前缘的高度恢复值、VAS和Oswestry评分的疼痛改善情况、骨水泥的渗漏方式及比率进行了分析。结果所有110个椎体均穿刺成功，所有96个患者手术效果均满意，椎体骨水泥分布比较理想，手术时间约20～40min／椎体，骨水泥注射量约5．4ml／椎体，术后VAS和Oswestry疼痛评分较术前均明显缓解（P〈0．01），椎体前缘高度明显改善（P〈0．01），手术的主要并发症是骨水泥渗漏，大部分渗漏发生在椎体前缘及前侧的静脉丛，总体发生率为56．3％。随访36个患者的40个椎体，1例有相邻椎体的骨折发生，1例患者治疗椎的前上缘（无骨水泥填充部位）发生了轻度的塌陷，但患者无不适。结论PKP或结合PVP是一种安全、方便、有效的治疗骨质疏松性椎体压缩性骨折的方法。Objective To discuss the methods and the effects of percutaneous kyphoplasty （PKP）in the treatment of thoracolumbar osteoporotic vertebral compression fractures （OVCFs）. Methods Retrospective anal- ysis was made on 110 vertebrae in 96 thoracolumbar OVCFs patients undergoing transpedicular unilateral PKP or PKP combined with percutaneous vertebroplasty（PVP）from Jan. 2004 to Nov, 2011. We analyzed the change of the anterior heights of the vertebra, the clinical outcomes using VAS and Oswestry before and after the treatment, and the rate of cement leakage. Results 85 vertebrae were treated with the PKP sucessfully, and 25 vertebrae were treated with both PKP and PVP sucessfully. All patients were satisfied with the diffusion of the cement. The operation time of each vertebra was about 20-40 minutes for one side. The injection volume of of each vertebra was about 5.4 ml. According to VAS and Oswestry, the pain was alleviated obviously after the operation （ P 〈 0. 01 ） and the anterior heights of the vertebrae changed （P 〈 0. 01 ）. The leakage of the cement was the only complication in these patients and most of the leakage happened at the anterior of the vertebrae and the vein nearby. The overall rate of the leakage was 56. 3%. For the 40 vertebrae of the 36 patients that were followed up, 1 patient had fracture in a neighbor vertebra and 1 patient had subsidence in the upper anterior edge of the treated vertebra where there was no cement filled in, but the patient had no discomfort. Conclusion PKP or PKP combined with PVP are safe, convenient and effective methods in treating OVCFs.

关 键 词：骨质疏松 胸腰椎骨折 经皮穿刺椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]