骨质疏松性椎体空腔样骨折对椎体后凸成形术疗效的影响  

Clinical outcome of Kyphoplasty for treatment of intravertebral fracture with or without cleft

作　　者：刘勇[1] 杨惠光[1] 张云庆[1] 周枫[1] 邓雄伟[1] 骆文兴[1] 陈亮[2] 杨惠林[2] 

机构地区：[1]江苏省江阴市人民医院骨科,214400 [2]苏州大学附属第一医院

出　　处：《中国骨与关节损伤杂志》2012年第11期993-995,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的评估骨质疏松性椎体空腔样骨折对椎体后凸成形术疗效的影响。方法自2004年3月一2009年8月对157例因骨质疏松性单椎体压缩骨折行椎体后凸成形术，以27例伤椎呈空腔样改变作为A组，选取27例伤椎无空腔样改变作为B组，两组年龄、性别构成及骨折压缩程度均相近。术后常规拍摄脊柱正侧位X线片及CT。比较两组椎体高度的恢复、后凸畸形的矫正、骨水泥的注入量及渗漏情况。采用疼痛视觉模拟评分（VAS）和Oswestry功能障碍指数评估两组的临床疗效。结果所有患者均顺利完成手术，两组术后VAS、ODI均得到明显改善，组间比较差异无统计学意义（P〉O．05）；A组椎体高度的恢复和后凸畸形的矫正优于B组，差异有统计学意义（P〈O．05）；A组骨水泥注入量大于B组，差异有统计学意义（P〈0．05）；两组间骨水泥渗漏率分别为11．1％和7．4％，差异无统计学意义（P〉O．05）。结论椎体空腔样骨折与无空腔样骨折相比，术后腰背痛、生活能力的改善及骨水泥渗漏的发生率相近．但是椎体高度的恢复和后凸畸形的矫正更明显。Objective To evaluate the clinical outcome of kyphoplasty for treatment of intravertebral fracture with or without deft. Methods From Mar 2004 to Aug 2009, 157 patients underwent kyphoplasty for treatment of single-level osteoporetie vertebral compression fracture. All of 27 patients with intravertebral fracture cleft were selected as A group. Other 27 without intravertebral fracture cleft as B group whose age, sex distribution, degree of vertebral compression were similar with A group. The therapeutic efficacy was compared between A and B group used by the Visual Analog Scale （VAS） and the Oswestry Disability Index （ODI）. The height and the kyphotie angle of the involved vertebral body, the cement injection volume and the rate of cement leakage were compared between A and B group used by lateral X-ray pre- and post-operation. Results All patients of two groups underwent the surgical procedure successfully. The VAS score, ODI systerm between two groups were similar （P 〉0.05）. A group had significant improvement in vertebral height and kyphotie angle of involved vertebral body compared with B group （P 〈0.05）. The cement injection volume in A group was greater than B group （P 〈0.05）. There was no significant difference in cement leakage between A and B group （P 〉0.05）. Conclusion Kyphoplasty for treatment of intravertebral fracture with or without cleft can achieve similar effect of relieving pain, improving life ability. The vertebral height recovery and kyphotie reduction of A group are better than B group after kyphoplasty. The rate of cement leakage between two groups is low and similar.

关 键 词：椎体后凸成形术 椎体空腔 骨质疏松性骨折 

分 类 号：R68[医药卫生—骨科学]