经皮椎体成形术治疗多节段陈旧性胸腰椎骨质疏松压缩骨折的临床研究  

Percutaneous vertebroplasty in treatment of multi-level senile osteoporotic vertebral compression fractures

作　　者：邵世坤[1] 刘军[1] 邢林卿[1] 张宝龙[1] 

机构地区：[1]郑州人民医院骨一科,郑州450003

出　　处：《临床医学》2013年第7期27-29,共3页Clinical Medicine

摘　　要：目的探讨经皮椎体成形术(PVP)治疗多节段陈旧性胸腰椎骨质疏松压缩骨折的临床疗效及安全性。方法应用PVP治疗42例共151节胸腰椎多节段陈旧性骨质疏松性椎体压缩骨折,术前分析患者影像学资料,结合患者症状、体征,明确责任椎及数量,采用功能障碍(ODI)及模拟视觉评分(VAS)评价术后患者疼痛缓解及日常活动功能恢复情况。结果 27例完成3节椎体,8例完成4节椎体,3例完成5节椎体,2例完成6节椎体,2例完成7节椎体。术前ODI平均值和VAS评分分别为79.3±11.85、47.25±1.09,术后1 d平均34.26±9.38、3.65±0.53;术后1 d疼痛缓解及日常活动功能恢复明显(P<0.05),随访1年时间内总体效果稳定。8节椎间盘漏,3节椎体旁软组织漏,2节椎体周围静脉引流。2例术中出现轻微骨水泥反应,舌下含服硝酸甘油,片刻缓解,继续完成手术。结论经皮椎体成形术治疗多节段陈旧性胸腰椎骨质疏松压缩骨折临床疗效显著,安全性高。术中须注意骨水泥反应和骨水泥外漏并发症。Objective To prospectively evaluate the surgical curative efficacy and safety of percutaneous vertebroplasty（PVP） in the treatment of multi-level senile osteoporotic vertebral compression fractures（OVCFs）.Methods PVP were performed in 42 patients（151 injured vertebral） with multi-level OVCFs.The imaging information was analyzed before operation,the injured vetebra and the number were identified according to the symptoms and signs.The pain relief and functional recovery of daily life was evaluated by oswestry disability Index（ODI） and visual analogue sale（VAS）.Results All procedures were performed successfully.Two patients had a transient high blood pressure and dyspnea,and recovered after sublingual nitroglycerin.The ODI and VAS improved from a mean preoperative score of 79.3 ± 11.85,47.25 ± 1.09,to a mean postoperative score of 34.26 ± 9.38,3.65 ± 0.53 one day afterward,and the pain relief and activities of daily living were significant recovered（P 0.05）.The overall effect was stable in the 1 year followed-up.The cement leakage included slight leakage to the adjacent disc（8 vertebral）,the paravertebral soft tissue（3 vertebral） and the perivertebral venous（2 vertebral）.Two cases of slight bone cement reaction occured during the operation,the operation was continued after relief of symptoms with subligual nitroglycerin.Conclusion PVP with cement to treat multi-level senile osteoporotic vertebral compression fractures is safe and effective.We should prevent the reaction of bone cement and bone cement leakage complications during the operation.

关 键 词：经皮椎体成形术 多节段 骨质疏松性椎体压缩骨折 

分 类 号：R687.3[医药卫生—骨科学]