CT引导下经皮椎体成形术治疗骨质疏松椎体压缩骨折的疗效评价  

Clinical efficacy of CT-guided percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures

作　　者：徐玉生[1] 朱海洋[1] 钟斌[1] 崔浩[1] 汪鑫[1] 理阳 

机构地区：[1]郑州大学第一附属医院骨科六病区,河南郑州450002

出　　处：《河南医学研究》2016年第2期213-216,共4页Henan Medical Research

摘　　要：目的评估CT精确引导下经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩骨折的疗效及其并发症的预防。方法 87例脊柱病变患者（共98个伤椎）行CT精确引导下经皮椎体成形术,记录术前、术后患者视觉模拟疼痛评分（visual analogue scale,VAS）、Oswestry功能障碍指数（oswestry disability index,ODI）以及远期疗效评估,并对结果进行统计学分析。结果术中应用优化的CT引导经皮椎体穿刺成功率100.00%,注入骨水泥2~9 ml,平均（4.17±1.34）ml。VAS评分术前（7.96±0.48）分,术后6月（1.89±0.47）分;术前ODI平均（72.85±6.84）分、术后6个月（9.24±8.30）分;两指标术后与术前比较,差异具有统计学意义（P〈0.05）。远期疗效WHO评估：总有效率为97.70%。术后即刻CT证实,共4例患者发生无症状性骨水泥渗漏,其中1例出现暂时性神经根性痛。结论术中CT精确引导可优化椎体成形术的手术操作,有效控制椎体骨折引起的疼痛,提高患者的生活质量,是一种微创、安全、高效的治疗方法。Objective To assess the clinical efficacy of intraoperative CT- guided percutaneous vertebroplasty（ PVP） in the treatment of osteoporotic vertebral compression fractures and prevention of complications. Methods Total 98 fracture vertebra of the 87 cases with vertebra accepted optimization of accurate CT- guided percutaneous vertebroplasty. The visual analogue scale,oswestry disability index and long- term curative effect evaluation in preoperation and postoperation were recorded,and the results were statistically analyzed. Results The success rate of optimized CT- guided PVP was 100. 00%. Bone cements were injected 2 ~ 9 ml,with an average of（ 4. 17 ± 1. 34） ml. The average score of VAS were（ 7. 96 ± 0. 48） and（ 1. 89 ± 0. 47）scores at preoperation and last follow up after the operation respectively. The average scores of ODI were（ 72. 85 ± 6. 84） and（ 9. 24 ± 8. 30） scores at preoperation and last follow up after the operation respectively. There were significant differences in ODI and VAS between preoperative and postoperative groups（ P〈0. 05）. The long term effect： the effective rate was 97. 7%. The immediately CT after operation confirmed that 4 patients suffered from asymptomatic bone cement leakage,and 1 of them had a temporary nerve root pain. Conclusion Precise intraoperative CT- guided can optimize percutaneous vertebroplasty procedure,control the pain caused by vertebral fractures effectively,increase spinal stability and improve the patient＇s quality of life. It is a minimally invasive,safe and effective treatment.

关 键 词：CT 椎体成形术 压缩骨折 

分 类 号：R683.2[医药卫生—骨科学]