同期再行经皮椎体成形术治疗骨质疏松性椎体压缩骨折术后疼痛不缓解  

Simultaneous repeat percutaneous vertebroplasty on the unrelieved pain after osteoporotic vertebral compression fractures surgery

作　　者：李东[1] 李卓凡 曹晨皓 王董 常志泳 周陈西 李开华[1] LI Dong;LI Zhuo-fan;CAO Chen-hao;WANG Dong;CHANG Zhi-yong;ZHOU Chen-xi;LI Kai-hua(Dept of Orthopaedics and Traumatology,the Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Province Hospital of Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院骨伤科,江苏南京210029

出　　处：《临床骨科杂志》2025年第1期16-19,共4页Journal of Clinical Orthopaedics

基　　金：国家自然科学基金(编号:81873105、82374164)。

摘　　要：目的探讨同期再行经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折术后疼痛不缓解的疗效。方法采用PVP和经皮椎体后凸成形术(PKP)治疗8例骨质疏松性椎体压缩骨折患者,因骨水泥弥散不佳而疼痛未缓解后同期再行PVP治疗。记录骨水泥注入量、疼痛VAS评分、ODI以及并发症发生情况。结果患者均随访1周。疼痛VAS评分:术前6~8(7.13±0.83)分,PKP或PVP后5~8(6.38±0.92)分,同期再行PVP后1~2(1.63±0.52)分,术后1周0~2(1.13±0.64)分。ODI:术前62%~78%(70.38%±5.50%),术后1周11%~18%(14.88%±2.17%)。PKP或PVP中骨水泥注入量5~8(6.13±0.99)ml/椎,同期再行PVP中骨水泥注入量2~3(2.25±0.46)ml/椎。术后骨水泥均弥散均匀,1例骨水泥椎旁渗漏,1例骨水泥椎间隙渗漏,均未发生神经损伤症状,无骨水泥椎管内渗漏。结论对于行PVP或PKP治疗后因骨水泥弥散不佳而疼痛不缓解的骨质疏松性椎体压缩骨折患者,同期再行PVP治疗可有效缓解疼痛,改善治疗效果,骨水泥有效弥散亦能预防椎体再塌陷。Objective To investigate simultaneous repeat percutaneous vertebroplasty(PVP)in the treatment of unrelieved pain after osteoporotic vertebral compression fracture OCVF surgery.Methods PVP and percutaneous kyphoplasty(PKP)were used to treat 8 patients with OVCFs,simultaneous repeat PVP was performed after unrelieved pain due to poor bone cement dispersion.The bone cement injection volume,pain VAS,ODI and complications incidence situation were recorded.Results All patients were followed up for 1 week.Pain VAS:they were 6~8(7.13±0.83)points before surgery,5~8(6.38±0.92)points after PKP or PVP,1~2(1.63±0.52)points after simultaneous repeat PVP,0~2(1.13±0.64)points at 1 week after surgery.ODI:The preoperative was 62%~78%(70.38%±5.50%),postoperative 1 week was 11%~18%(14.88%±2.17%).The injection volume of bone cement in per vertebra:PKP or PVP was 5~8(6.13±0.99)ml,and the simultaneous repeat PVP was 2~3(2.25±0.46)ml.The bone cement was uniformly dispersed after operation,paravertebral leakage occurred in 1 case and intervertebral space leakage occurred in 1 case,there were no neurological symptoms or intraspinal leakage of bone cement.Conclusions For OVCFs patients whose pain are not relieved due to poor bone cement dispersion after PVP or PKP treatment,simultaneous repeat PVP can effectively relieve pain and improve treatment effect,and effective bone cement dispersion can also prevent vertebral recollapse.

关 键 词：骨质疏松性椎体压缩骨折 经皮椎体成形术 经皮椎体后凸成形术 

分 类 号：R683.2[医药卫生—骨科学] R687.3[医药卫生—外科学]