椎体后凸成形术在上中胸椎骨质疏松压缩性骨折治疗中的临床应用研究  

Application of kyphoplasty in the treatment of osteoporotic compression fractures of high-middle thoracic vertebrae

作　　者：梁绛槟 张智海[1] 王冉东 黄进[1] 陆冬舰 

机构地区：[1]航空总医院骨科,北京100012

出　　处：《中国骨质疏松杂志》2013年第7期718-720,共3页Chinese Journal of Osteoporosis

摘　　要：目的评价穿刺椎体后凸成形术治疗骨质疏松性中上段胸椎压缩性骨折的临床疗效。方法 2007年12月～2010年12月在C臂X光机引导下共使用经皮椎体后凸成形术(PKP)治疗骨质疏松型上中胸段椎体(T3-T8)压缩性骨折患者20例24椎,其中:男性2例,女性18例,年龄65～85岁,平均75岁。术后18例患者随访8～30个月,平均16个月。对患者术前、术后3天及末次随访时进行术后采用疼痛视觉模拟评分(visual analogue scale,VAS)评分,Oswestry功能评分、后凸Cobb角、椎体前中柱的平均高度等指标来评估疗效。结果术后较术前VAS评分和Oswestry功能评分都有明显下降,与术前相比有统计学差异(P<0.05);后凸Cobb角及椎体前中柱的平均高度与术前比较有统计学差异(P<0.05)。结论 PKP能有效缓解老年骨质疏松性上中胸段压缩性骨折所引起的疼痛,改善患者的脊柱功能,减少镇痛药依赖以及改善生活质量,是一种安全有效的微创治疗方法。Objective To evaluate the efficacy of percutaneous kyphoplasty for the treatment of osteoporotic high-middle thoracic vertebral compression fractures. Methods A total of 20 patients, who had 24 high-middle thoracic vertebral compression fractures （T3-TS）, underwent percutaneous kyphoplasty （PKP） from December 2007 to December 2010, under the guidance of C-arm X-ray. Among them, two were men and 18 were women, aged from 65 to 85 years old, with an average age of 75 years old. After the operation, 18 patients were followed up for 8 -30 months, with an average follow- up of 16 months. Visual analogue scale （VAS） , Oswestry score, Cobb angle function of kyphosis, and vertebral anterior and middle column average height were measured before the operation, 3 days after the operation, and at the last follow-up, in order to assess the effect. Results Postoperative VAS score and Oswestry score decreased obviously compared with those before the operation （P 〈 0.05）. The kyphosis angle Cobb and the anterior vertebral column average height were significantly different with those before the operation （ P 〈 0.05 ）. Conclusion PKP can effectively alleviate the pain caused by senile osteoporotic upper thoracic compression fractures, improve patients＇ spinal function, reduce drug dependence, and improve the quality of life. It is a safe and effective minimal invasive treatment.

关 键 词：骨质疏松 上中胸段 压缩性骨折 后凸成形术 

分 类 号：R681[医药卫生—骨科学]