经皮椎体后凸成形术治疗老年胸腰椎骨质疏松性骨折的临床与探讨.pdfVIP

经皮椎体后凸成形术治疗老年胸腰椎骨质疏松性骨折的临床探讨 刘志礼* 陈宣银 黄山虎 刘家明 熊绪 [摘要] 目的：探讨经皮椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗老年 骨疏松性椎体压缩性骨折（osteoporosis vertebral compression fracture，OVCF） 的临床疗效及安全性。方法：2010 年 1 月-2012 年 12 月期间，我院诊治的 95 例（110 椎体）老年胸腰椎骨质疏松性椎体压缩性骨折患者，均给予经皮椎体后凸成形术，平均 随访 10 个月，比较术前、术后疼痛视觉模拟评分（VAS）、椎体前中柱平均高度、Oswestry 功能评分、后凸畸形矫正情况（Cobb 角）。结果：与术前比较，术后 V A S 明显降低， 差异有统计学意义 (P0.01 )；术后椎体前中柱平均高度及Cobb 角无明显变化，差异 无统计学意义（P0.05）；术后 Oswestry 功能评分显著低于术前，差异有统计学意义 (P0.01 )，术中未发现骨水泥向椎管内渗漏。结论：对于老年胸腰椎骨质疏松性骨折 患者，PKP 能安全有效的缓解椎体压缩性骨折引起的疼痛，改善患者脊柱功能及生活质 量，但对后凸畸形的矫正及椎体高度的恢复作用有限。 [关键词] 经皮椎体后凸成形术；骨质疏松；椎体骨折 Percutaneous kyphoplasty for senile osteoporosic vertebral compression fractures [Abstract] Objective To explore the clinical effect and safety of percutaneous kyphoplasty （PKP ）in the treatment of senile osteoporosic vertebral compression fractures. Methods 95 patients with 110 lumbar lesions were treated with PKP between January 2010 to December 2012. ALL cases have been followed up for ten months. The visual analogue scale （VAS） of pain, mean anterior-middle vertebral spinal height，Oswestry function score, and conditions of kyphosis correction （Cobb angle）before and after operation were compared. Results Postoperative VAS of patients obviously decreased compared with operation before(P0.01 ), but there were no significant differences in mean anterior-middle vertebral spinal height and Cobb angle （P0.05 ）. Postoperative Oswestry functional score of patients obviously decreased compared with operation before. Conclusions For elderly patients with thoracolumbar osteoporotic fractures, PKP can effectively alleviate the pain caused by vertebral compression fractures, and improve patients with spinal function and quality of life. [Key words] percutaneous kyphoplasty；osteoporosis；vertebral compression fracture 作者单位：330006 南昌大学第一附属医院骨科 通信作者：刘志礼，zgm7977@163.co