经皮椎体后凸成形术治疗中上胸椎骨质疏松性椎体压缩骨折  

Percutaneous kyphoplasty for the treatment of middle and upper thoracic osteoporotic vertebral compression fracture

作　　者：尹思 刘伟[2] 杜恒 赵为公 张银刚[1] 杨益民 李新友 张小卫 YIN Si;LIU Wei;DU Heng;ZHAO Wei-gong;ZHANG Yin-gang;YANG Yi-min;LI Xin-you;ZHANG Xiao-wei(Dept of Orthopaedics, the First Affiliated Hospital of Xi′an Jiaotong University, Xi′an, Shaanxi 710065, China)

机构地区：[1]西安交通大学第一附属医院骨科,陕西西安710065 [2]榆林市第一医院骨二科,陕西榆林719000

出　　处：《临床骨科杂志》2020年第2期157-160,共4页Journal of Clinical Orthopaedics

基　　金：陕西省自然科学基础研究计划(编号:2019JM-558);中央高校基本科研业务费项目(编号:xjh012019062)。

摘　　要：目的探讨经皮椎体后凸成形术(PKP)治疗中上胸椎骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法采用PKP手术治疗44例中上胸椎(T8椎体及以上胸椎)OVCF患者。记录手术前后疼痛VAS评分、伤椎Cobb角和并发症情况。结果患者均获得随访,时间6~31(14.4±6.0)个月。单个椎体内骨水泥注射剂量1.5~3.8(2.4±0.5)ml,手术时间28~110(45.4±13.8)min。术后3 d、术后3个月、末次随访时,VAS评分均较术前显著降低(P<0.01),Cobb角较术前显著减小(P<0.05)。术中发生骨水泥渗漏6例,均无神经压迫症状;术后发生3例其他椎体再骨折,其中2例再次行PKP治疗,1例经非手术治疗后缓解。结论PKP治疗中上胸椎OVCF的近期疗效满意。Objective To evaluate the clinical outcomes of percutaneous kyphoplasty(PKP)for the treatment of the middle and upper thoracic osteoporotic vertebral compression fracture(OVCF).Methods The 44 patients with middle and upper thoracic OVCF(T8 and upper vertebrae)were treated with PKP.The pain visual analogue scale(VAS),Cobb angles,and complications were observed.Results All patients were followed up for 6~31(14.4±6.0)months.The injected dose of bone cement in every vertebra was 1.5~3.8(2.4±0.5)ml,and the operation time was 28~110(45.4±13.8)min in every vertebra.The VAS was decreased significantly at 3 d and 3 weeks after operation,and the last follow-up when compared with those at preoperation(P<0.01).The Cobb angles were significantly decreased at 3 d and 3 weeks after operation,and the last follow-up when compared with those at preoperation(P<0.05).Cement leakage occurred in 6 cases intraoperatively,with no symptom of nerve compression.Postoperative refracture occurred in 3 cases,two of them were treated by PKP again,and the other one was relieved by conservative treatment.Conclusions The short-term effect of PKP is obvious for the treatment of middle and upper thoracic OVCF.

关 键 词：经皮椎体后凸成形术 骨质疏松性椎体压缩骨折 胸椎骨折 骨水泥 

分 类 号：R681.5[医药卫生—骨科学] R683.2[医药卫生—外科学]