PKP联合小切口椎板开窗减压治疗伴有脊髓或神经根损伤症状的骨质疏松性压缩骨折  

Analysis of PKP and Lumbar Discherniation by Small Incision Discectomy in Treatment of Osteoporotic Vertebral Compression Fractures Patients with Spinal Cord or Nerve Root Injury

作　　者：巫桂兵 贾叙锋[2] 冯大雄[3] 

机构地区：[1]四川省合江县人民医院骨科,四川合江646200 [2]简阳市人民医院骨科,四川简阳641400 [3]泸州医学院附属医院脊柱外科,四川泸州646000

出　　处：《中外医疗》2017年第11期44-46,共3页China & Foreign Medical Treatment

基　　金：泸州市科技支撑计划项目(C20150016)

摘　　要：目的探讨经皮椎体后凸成形术(PKP)联合小切口椎板开窗减压治疗伴有脊髓或神经根损伤症状的骨质疏松性压缩骨折的临床疗效。方法回顾性分析该院2013年9月—2015年1月收治的15例伴有脊髓或神经根损伤症状的骨质疏性压缩骨折患者,先行小切口椎板开窗解除脊髓及神经根的压迫,然后直视下经椎弓根穿刺,完成PKP操作.术后以疼痛视觉模拟评分(VAS)及ASIS分级评定患者局部疼痛缓解及神经功能的恢复情况。结果 15例患者均顺利完成手术,术后患者腰背部疼痛缓解,神经受压及椎管狭窄症状消失,术中共2节椎体发生骨水泥渗漏,但未出现不适症状.15例患者均获随访,随访时间9~24个月,平均(16±0.4)个月,术后1周及末次随访时VAS评分均较术前明显降低(P<0.05),末次随访时ASIS分级为:D级2例,E级13例。结论 PKP联合小切口椎板减压治疗伴有脊髓或神经根损伤症状的骨质疏松性压缩骨折,能有效减轻局部疼痛症状,改善神经功能.为该类患者提供了一种疗效确切的选择。Objective To study the clinical curative effect of lumbar discherniation by small incision discectomy in treatment of osteoporotic vertebral compression fractures patients with spinal cord or nerve root injury. Methods 15 cases of osteoporotic vertebral compression fractures patients with spinal cord or nerve root injury admitted and treated in our hospital from September 2013 to January 2015 were selected and were given the vertebral lamina fenestration with small incision and then finished the PKP operation, and the regional pain relief and recovery of nerve function of patients were evaluated by VAS and ASIS. Results 15 cases successfully finished the operation, and the pains in the back and waist of patients after operation were relieved and there were two cases with bone cement leakage but without discomfort symptoms, 15 cases were followed-up, and the follow time was between 9 months and 24 months,(16±0.4)months on average, and the VAS score in 1 week after operation and last follow-up obviously decreased compared with those before operation(P<0.05), and the ASIS classification at final follow-up: 2 cases in D and 13 cases in E. Conclusion PKP and lumbar discherniation by small incision discectomy in treatment of osteoporotic vertebral compression fractures patients with spinal cord or nerve root injury can effectively relieve the regional pains symptoms and improve the nerve function, it provides the selection with definite curative effect for patients.

关 键 词：PKP 椎板开窗 减压 脊髓损伤 骨质疏松性压缩 

分 类 号：R687.3[医药卫生—骨科学]