可调角度骨水泥注入器单侧PKP治疗老年骨质疏松胸腰段椎体压缩性骨折34例  

34 Cases of Clinical Report of Steerable Unilateral PercutaneousKyphoplasty in the Treatment of Osteoporosis ThoracicLumbar Vertebral Compression Fractures

作　　者：申云杰 段登海 任定宝 苏明华[1] 聂薪洁 王恩斌[1] 李垠莹 杨仕成 杨志新 SHEN Yunjie;DUAN Denghai;REN Dingbao;SU Minghua;NIE Xinjie;WANG Enbin;LI Yinying;YANG Shicheng;YANG Zhixin(Baoshan Hospital of Traditional Chinese Medicine(the First Affiliated Hospital of Baoshan College of Traditional Chinese Medicine),Baoshan 678000,Yunnan China;Hebei Medical University,Shijiazhuang 050017,China;Hubei Hospital of Traditional Chinese Medicine(Affiliated Hospital of Hubei University of Traditional Chinese Medicine),Wuhan 430074,China)

机构地区：[1]云南保山市中医医院/保山中医药高等专科学校第一附属医院,云南保山678000 [2]河北医科大学 [3]湖北省中医院/湖北中医药大学附属医院

出　　处：《中国中医骨伤科杂志》2021年第8期66-70,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：保山中医药高等专科学校2021年度校级科技计划项目(2021K011)。

摘　　要：目的:评价可调角度骨水泥注入器单侧PKP(Steerable Percutaneous Kyphoplasty,SPKP)治疗老年骨质疏松胸腰段椎体压缩性骨折临床疗效。方法:收集2019年10月至2020年6月,在本院就诊34例确诊骨质疏松新鲜胸腰段椎体压缩性骨折(T_(11)~L_(2)脊柱节段)的患者,全部采用C臂机引导下SPKP治疗。患者术后行康复指导训练,记录患者术前及术后随访时的胸腰部疼痛视觉模拟评分(VAS)和Oswestry功能障碍指数(Oswestry Disability Index,ODI),评价临床效果,术后SST问卷评估其疗效。结果:34例均获得随访,随访时间平均6个月。术后复查胸腰椎DR:椎体骨折稳定,骨水泥无明显渗漏及移位,术后6个月患者未发现病椎再次骨折,无胸腰脊段疼痛等并发症。末次随访(6个月)疼痛VAS评分为(2.2±0.3)分,较术前(8.1±1.2)分明显降低,差异有统计学意义(t=3.704,P=0.009;F=22.381,P=0.003)。腰椎功能障碍指数评分末次随访(6个月)为(28.6±3.2)分,较术前(86.3±4.5)分明显降低,差异有统计学意义(t=2.136,P=0.006;F=16.452,P=0.002)。末次随访SST问卷调查显示患者胸腰背疼痛明显消失,胸腰椎活动及功能恢复正常,患者满意度高。结论:SPKP是一种治疗老年性骨质疏松胸腰段椎体压缩性骨折新型适宜的手术方式,具有较好的患椎内骨水泥分布弥散、满意的椎体骨折复位和复位维持、明显的患者术后胸腰椎疼痛减轻及功能改善等优点。Objective:To evaluate the steerable unilateral percutaneous kyphoplasty(SPKP)in the treatment of osteoporosis thoracic lumbar vertebral compression fractures(OVCF)disease clinical curative effect.Methods:34 cases osteoporosis fresh thoracic lumbar vertebral compression fractures(T11 to L2)patients treated by SPKP from October 2019 to June2020 were respectively studied.Patients were instructed by postoperative rehabilitation guidance training after this surgery.Thoracic lumbar pain visual analog scale(VAS),Oswestry disability index(ODI)evaluation of clinical effect and postoperative SST questionnaire were carried out to evaluate the curative effect.Results:34 cases were follow-up with6 months on average.Postoperative thoracolumbar DR showed that satisfied stability of fractured vertebral body,no obvious leakage of bone cement and shift,postoperative did not come on patients with vertebral fractures,again have no thoracic lumbar spinal segment complications such as pain.The pain VAS score decreased from(8.1±1.2)to(2.2±0.3)after 6 month’s follow-up(t=3.704,P=0.009;F=22.381,P=0.003),the statistical model is meaningful.ODI(%)score at the end of follow-up decreased from(86.3±4.5)to(28.6±3.2)(t=2.136,P=0.006;F=16.452,P=0.002),the statistical model is meaningful.The last line of SST questionnaire follow-up showed that patients with thoracic lumbar back pain disappears,recovery function of thoracolumbar activity and high patient satisfaction.Conclusion:SPKP is a new suitable operation method for senile osteoporosis thoracic lumbar vertebral compression fractures,which has advantages of vertebral bone cement distribution,satisfied reset and maintain ability for fractured vertebral body,obvious pain relief and functional improvement.

关 键 词：胸腰段椎体 老年性骨质疏松 椎体新鲜压缩性骨折 

分 类 号：R683.2[医药卫生—骨科学]