经皮椎体后凸成形术治疗老年性骨质疏松性胸腰椎压缩性骨折的临床疗效  

Clinical efficacy of percutaneous kyphoplasty for the treatment of senile osteoporotic thoracolumbar vertebra compression fracture

作　　者：杨明礼 谢海洋[2] 张超[2] 蒋成[2] Yang Mingli;Xie Haiyang;Zhang Chao;Jiang Cheng(Dazhou Orthopaedic Hospital,Dazhou Sichuan 635000,China;Affiliated Hospital of North Sichuan Medical College,Nanchong Sichuan 637000,China)

机构地区：[1]达州骨科医院,四川达州635000 [2]川北医学院附属医院,四川南充637000

出　　处：《保健医学研究与实践》2018年第4期23-27,共5页Health Medicine Research and Practice

摘　　要：目的探讨应用经皮椎体后凸成形术(PKP)治疗老年性骨质疏松性胸腰椎压缩性骨折(OVCF)的临床疗效。方法选取2012年3月-2017年4月四川省某医院诊治的225例老年性OVCF患者为研究对象。所有患者均行PKP治疗。比较术前、术后1d、术后1个月及术后3个月时患者的功能障碍情况及疼痛程度;比较患者术前、术后1d、术后1个月及术后3个月时患者的伤椎前缘高度及Cobb角;观察患者并发症发生情况。结果术后1d、术后1个月及术后3个月时患者VAS评分及Oswestry功能障碍指数均低于术前,差异有统计学意义(P<0.05)。术后1个月及术后3个月时患者VAS评分及Oswestry功能障碍指数均低于术后1d,差异有统计学意义(P<0.05)。术后1d、术后1个月及术后3个月时患者伤椎前缘高度均高于术前,差异有统计学意义(P<0.05)。术后1d、术后1个月及术后3个月时患者Cobb角均小于术前,差异有统计学意义(P<0.05)。1例T12椎体压缩性骨折患者在术中发生骨水泥渗漏至椎管前壁,术后24h左右逐渐出现右下肢瘫痪症状;1例患者在穿刺过程中发生了硬脊膜损伤。结论 PKP应用于老年性OVCF的治疗中,可提高老年性OVCF的治疗效果,降低患者发生骨水泥渗漏、脊髓或神经损伤的风险,缓解患者疼痛,提高患者生活质量,值得临床推广应用。Objective To assess the clinical efficacy of percutaneous kyphoplasty（PKP）for the treatment of senile osteoporotic thoracolumbar vertebra compression fracture（OVCF）.Methods A total of 225 patients with senile OVCF treated at a Sichuan hospital between March 2012 and April 2017 were included in this study.All patients underwent PKP.The Oswestry disability index,pain visual analog scale（VAS）score,anterior column height and Cobb′s angle of the affected vertebra were measured before surgery,1 day,1 month and 3 months after surgery.The occurrence of complications was also recorded.Results At 1 day,1 month and 3 months after surgery,both VAS and Oswestry scores were significantly lower than those before surgery（P〈0.05）.At 1 month and 3 months after surgery,both VAS and Oswestry scores were significantly lower than the values obtained 1 day after surgery（P〈0.05）.At 1 day,1 month and 3 months after surgery,the anterior column height of the affected vertebra was significantly higher compared with that before surgery（P〈0.05）,while the Cobb′s angle was significantly smaller than that before surgery（P〈0.05）.Intraoperatively,bone cement leakage into the anterior spinal canal occurred in one patient with T12 compression fracture,who experienced paralytic symptoms of the right lower extremity about 24 hours after surgery.One patient suffered dural injury in the process of puncture.Conclusion For patients diagnosed with senile OVCF,PKP is associated with favorable efficacy and a low risk of bone cement leakage and spinal or nerve injuries,which may help to relieve pain,improve quality of life,and deserve widespread clinical application.

关 键 词：经皮椎体后凸成形术 老年性骨质疏松性胸腰椎压缩性骨折 疼痛 

分 类 号：R683.2[医药卫生—骨科学]