弯角椎体成形技术治疗老年骨质疏松性椎体压缩骨折的近期疗效  

Percutaneous corner vertebroplasty technique in the treatment of senile osteoporotic vertebral compression fractures

作　　者：马力[1] 刘艺明[1] 王善松[1] 杜怡斌[1] 王晓陆[1] 李春[1] 

机构地区：[1]合肥市第一人民医院骨科,安徽合肥230061

出　　处：《临床骨科杂志》2017年第3期286-288,292,共4页Journal of Clinical Orthopaedics

摘　　要：目的评价弯角椎体成形技术(PCVP)治疗老年骨质疏松性椎体压缩骨折的近期疗效。方法对26例胸腰椎骨质疏松性压缩骨折患者(31个椎体)行PCVP治疗。记录手术时间、术中出血量、骨水泥注入量和术后并发症情况。比较术前、术后1 d及术后2个月患者伤椎Cobb角和ODI;术前、术后1 d及术后2个月采用简化麦吉尔疼痛问卷了解患者疼痛改善情况;采用简易生活质量量表观察患者术前、术后1个月及术后2个月的生活质量。结果患者均获得2个月随访。手术时间20~50(26.44±1.35)min/椎,术中出血量6~12(10.14±0.21)ml,骨水泥注入量4.7~7.8(5.51±1.29)ml/椎。术后26例均未出现椎体两侧骨水泥分布不均现象。术后1 d及术后2个月ODI均较手术前降低,术后2个月较术后1 d进一步降低,差异均有统计学意义(P<0.05);术后1 d及术后2个月伤椎Cobb角与术前比较均无明显变化(P>0.05)。术后1 d及术后2个月与术前比较,PRI、VAS、PPI评分均明显降低,术后2个月较术后1 d进一步降低,差异均有统计学意义(P<0.05)。治疗前7例生活质量良好(7/26),术后1个月22例生活质量良好(22/26),术后2个月24例生活质量良好(24/26),差异均有统计学意义(P<0.05)。31个椎体中,椎体附近软组织渗漏3个,未出现椎管内骨水泥渗漏或肺栓塞等相关严重并发症。结论 PCVP治疗骨质疏松性椎体骨折能改善患者的生活质量,近期疗效满意。Objective To evaluate the effect of percutaneous corner vertebroplasty（PCVP） technique in the treatment of senile osteoporotic vertebral compression fractures.Methods The 26 cases of senile osteoporotic thoracolumbar compression fractures （31 vertebraes） were treated with PCVP,and the operation time,blood loss,bone cement injection volume and postoperative complications were observed and recorded.The preoperative and postoperative 1 d and 2 months of the patients with injury vertebral Cobb angle and Oswestry disability index were compared.The quality of life preoperative and postoperative 1 month and 2 months were observed by simplified McGill pain questionnaire and the simplified quality of life questionnaire.Results All 26 patients were followed up for 2 months postoperation.The operation time was 20~50 （26.44±1.35） min/ vertebra.The bleeding volume during operation was 6~12 （10.14±0.21） ml,and the bone cement injection volume was 4.7~7.8 （5.51±1.29） ml/vertebra.The uneven distribution of cement in both spine sides did not appear in 26 cases after operation.At 1 d after operation and 2 months follow-up,ODI were lower than those before operation,at 2 months follow-up,compared with postoperative 1 d,which was further decreased,the differences were statistically significant （P〈0.05）.One day after operation and 2 months follow-up of vertebral Cobb angle had no significant change,compared with before surgery （P〉0.05）.Compared with the preoperative,postoperative 1 d and 2 months follow-up,PRI,VAS and PPI scores were significantly lower,and 2 months follow-up was lower than the 1 month after operation,the difference was statistically significant （P〈0.05）.Seven patients were good quality of life （7/26） preoperatively,1 month after surgery,22 cases of good quality of life （22/26）,at 2 months follow-up,24 cases with good quality of life （24/26）,the difference was statistically significant （P〈0.05）.In the 31 vertebras,there were 3 soft tissue leaks around the vert

关 键 词：弯角椎体成形术 椎体压缩骨折 伤椎前缘高度 

分 类 号：R683.5[医药卫生—骨科学] R687.3[医药卫生—外科学]