球囊扩张经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折  

Percutaneous kyphoplastyfor treating osteoporotic vertebral compressive fractures

作　　者：高建文[1] 

机构地区：[1]济宁市第一人民医院脊柱外科,山东济宁272000

出　　处：《现代医药卫生》2012年第15期2277-2278,共2页Journal of Modern Medicine & Health

摘　　要：目的总结球囊扩张经皮椎体后凸成形术在治疗骨质疏松性椎体压缩性骨折中的经验和体会。方法回顾性分析应用球囊扩张经皮椎体后凸成形术治疗的骨质疏松性椎体压缩性骨折患者(20例31个椎体)的临床资料,年龄59～83岁,平均67岁。椎体骨折位于T6～L4,术前对20例患者均拍摄X线片、CT及磁共振成像,手术采用局部麻醉,经双侧入路球囊扩张注射骨水泥14例,单侧注射6例,手术前后进行疼痛视觉评分(VAS)、椎体矢状面指数测量,进行配对t检验统计分析。结果所有患者均得到随访,VAS由术前平均8.5分降为术后2.2分(终末随访为2.1分),差异有统计学意义(P<0.01),椎体矢状面指数(SI)由术前平均55%恢复至术后89%(终末随访为84%),差异有统计学意义(P<0.01);术后94%患者疼痛明显减轻或消失,1例术中发生少量骨水泥渗漏至椎体旁,经术后长期观察,未造成任何神经及血管并发症。结论球囊扩张经皮椎体后凸成形术是一种理想的治疗骨质疏松性椎体压缩性骨折的方法。Objective To summarize the expierence and understanding of percutaneous kyphoplasty （PKP） in treating osteoporotic vertebral compressive fractures（OVCF）. Methods The clinical data in 20 cases of OVCF（31 vertebrae） undergoing PKP were retrospectively analyzed. The patients aged 59-83 years old （average 67 years old）. The injured vertebrae were located in T6 -L4. All 20 cases had plain X-rays and CT scan as well as MRI images preoperatively. The operation adopted local anesthesia and bone cement was injected by bilateral approach in 14 cases and by unilateral approach in 6 cases. Before and after operation,the visual analogue scale （VAS） scores were estimated and the sagittal index （SI） of the vertebrae were measured. The data were statistically analyzed with the method of paired t-test. Results All the patients were followed up. The VAS scores were re duced from 8.5 points before operation to 2.5 points after operation with statistical differenc （P〈0.01） and SI was increased from average 55% before operation to 89% after operation with statistical difference （P〈0.01）. The back pain in 94 % of the patients was obviously relieved or disappeared after operation. The small amount of paravertebral bone cement leakage was in 1 case, which did not cause any nervous and vascular complications during long period postoperative observation. Conclusion PKP is an ideal method to treat OVCF.

关 键 词：椎体成形术 骨折固定术 骨质疏松 脊柱骨折/外科学 经皮椎体后凸成形术 

分 类 号：R683.2[医药卫生—骨科学]