经皮椎体后凸成形术治疗胸腰椎椎体骨折的疗效观察  

Clinical effect of percutaneous kyphoplasty in the treatment of thoracolumbar vertebral fracture

作　　者：张伟[1] 杨金华[1] 王筱林[1] 黄开[1] 

机构地区：[1]江苏省常熟市第二人民医院脊柱外科,215500

出　　处：《中国骨与关节损伤杂志》2014年第7期657-659,共3页Chinese Journal of Bone and Joint Injury

摘　　要：目的 探讨经皮椎体后凸成形术（PKP）治疗胸腰椎椎体骨折的临床疗效。方法 回顾性分析自2007-12-2014-02对46例椎体骨折共52个患椎实施PKP的情况,对术前、术后患椎的矢状面指数（VSI）,模拟视觉类比评分（VAS）,功能障碍指数（ODI）进行对比。结果 46例均顺利完成手术,随访时间6周-74个月,平均（27.3±4.7）周。伤椎VSI、VAS和ODI评分术后与术前比较差异有统计学意义：术前、术后2周、术后半年VSI为（0.89±0.41）、（0.93±0.33）、（0.91±0.26）（P〈0.05）;VAS评分为（9.35±0.72）、（1.92±1.32）、（2.1±1.26）分（P〈0.01）;ODI评分为（83.46±5.66）%、（20.45±3.65）%、（28.40±5.70）%（P〈0.01）。1例术后病理证实为结核,后改前路患椎切除内固定术。结论 经皮椎体后凸成形术具有较好止痛效果和脊椎功能的恢复;术中常规病理检查以防误诊;对于骨质疏松患者仍有必要行抗骨质疏松治疗。Objective To evaluate the spinal fracture clinical treatment results of percutaneous kyphoplasty （PKP）. MethodsFrom December 2007 to February 2014,46 patients （52 vertebrae） were treated by kyphoplasty for symptomatic fractures. TheVertebral Sagittal Index（VSI） and Visual Analogue Scale（VAS） and Oswestry Disability Index（ODI） were compared before andafter operation. Results Forty six patients successfully completed operation. All of them were followed up for an average of27.3 months （ranged from 6 weeks to 74 months）. VSI was （0.89±0.41） preoperatively,（0.93±0.33） two weeks postoperativelyand （0.91±0.26） half a year postoperatively. The difference of VSI in preoperative group was statistically difference comparedto two weeks postoperative group or half a year postoperative group （P 〈0.05）; The VAS score was （9.35±0.72） preoperativelyand （1.92±1.32） two weeks postoperatively, （2.1±1.26） half a year postoperatively. There was significant difference betweenpreoperative group and two weeks postoperative group or half a year postoperative group（P 〈0.01）. The ODI score was （83.46±5.66） preoperatively and （20.45 ±3.65） two weeks postoperatively, （28.40 ±5.70） half a year postoperatively. There wassignificant difference between preoperative group and two weeks postoperative group or half a year postoperative group （P 〈0.01）. One case of postoperative pathology confirmed for TB, in the end, changed to operation of anterior vertebral resectionand internal fLXation. Conclusion Pereutaneous kyphoplasty has a good analgesic effect and the recovery of spinal cordfunction. It is necessary to do conventional pathological examination to prevent misdiagnosis during operation. It is necessaryfor patients of osteoporotic fractures to receive anti-osteoperosis treatment.

关 键 词：椎体骨折 骨水泥 球囊扩张 椎体后凸成形术 

分 类 号：R687.3[医药卫生—骨科学]