经皮椎体后凸成形术联合唑来磷酸治疗骨质疏松椎体压缩性骨折  

Percutaneous vertebroplasty combined with zoledronic acid for the treatment of osteoporotic vertebral compression fractures

作　　者：刘永强[1] 范金鹏[1] 王朝君[1] 徐凤周[1] 李一鹏[1] 王韦江[1] 隋孟伟[1] 李宝存[1] 

机构地区：[1]石家庄市中心医院骨科,石家庄050011

出　　处：《中国骨质疏松杂志》2013年第9期985-987,共3页Chinese Journal of Osteoporosis

摘　　要：目的探讨经皮椎体后凸成形术联合唑来磷酸抗骨质疏松药物治疗骨质疏松性椎体压缩骨折的临床疗效。方法回顾性分析2007年3月到2011年3月我院开展的89例女性绝经后椎体压缩骨折患者(共162个椎体)经皮球囊扩张椎体后凸成形术治疗效果,所有手术均在C型臂X线机引导下,经椎弓根穿刺球囊撑开后注入聚甲基丙烯酸甲酯,术后联合唑来磷酸及活性钙药物抗骨质疏松治疗,术前及术后1周及术后12个月分别进行视觉模拟疼痛评分(visual analogue scale,VAS)、测量伤椎压缩程度、矢状面Cobb角以评价治疗效果。结果所有患者均无临床并发症,术后1周及术后12个月VAS评分、伤椎压缩程度、矢状面Cobb角与手术前比较有明显差异(P<0.01),均较术前有明显改善,疼痛明显缓解或消失,伤椎压缩明显恢复,功能改善。结论经皮椎体后凸成形术联合唑来磷酸抗骨质疏松药物治疗骨质疏松性椎体压缩骨折是一种安全、有效、微创的治疗方法,值得临床推广。Objective To evaluate the clinical efficacy of percutaneous vertebroplasty combined with zoledronic acid for the treatment of osteoporotic vertebral compression fractures. Methods The clinical data of 89 patients （ 162 vertebrae）, who had osteoporotic vertebral compression fractures （OVCF） and received percutaneous kyphoplasty （PKP） from March 2007 to March 2011 in our department, were retrospectively analyzed. All the operations were under the guidance of C-arm fluoroscopy. After pedicle puncture and balloon expansion, the injection of bone cement （MPPA） was performed. The patients were treated with zoledronic acid and anti- osteoporosis drugs including calcium and active vitamin D after the operation. The clinical efficacy was evaluated according to the visual analogue scale score （VAS） , the degree of vertebral compression, and the spine convex Cobb angle before and after the operation （the 1s＇ week and the 12＇4 month）. Results No complications were observed in all patients. The VAS score, the degree of vertebral compression, and the spine convex Cobb angle at the 1~t week and the 12th month after the operation were significantly different compared with those before the operation （P 〈 0. 01 ）. The pain of patients had relieved significantly or even disappeared. The compression of fractured vertebrae had significant recovery with improved functions. Conclusion PKP combined with zoledronic acid for the treatment of OVCF is a safe, effective, and minimally invasive method. It is worthy of clinical promotion.

关 键 词：经椎弓根 骨质疏松 椎体压缩骨折 椎体后凸成形术 唑来磷酸 

分 类 号：R681[医药卫生—骨科学]