经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床研究.docVIP

经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折的临床研究 　　作者：刘明建，陈岳峰 作者单位：广东省东莞市石排医院,广东 东莞 523330;湖南省汨罗市人民医院,湖南 汨罗 414400 　　【摘要】目的：探讨经皮椎体成形术在治疗老年骨质疏松性椎体压缩性骨折中的疗效。方法：老年骨质疏松性压缩性骨折患者28 例，接受了椎体成形术，患者均有背部疼痛，在X线透视引导下，经单侧椎弓根入路行 PVP，完成36个椎体成形术，术后患者随访 3～ 24 个月。结果：28例(36个椎体)均成功完成穿刺和PMMA的注射，每个椎体注射PMMA2～6mL，平均3.5mL。疼痛完全缓解22 例，部分缓解 6 例，疼痛无加重或复发，椎体无压缩。结论：椎体成形术为骨质疏松压缩性骨折经保守治疗无效患者提供了一种安全、微创、有效的治疗方法。 　　【关键词】 椎体成形术;骨质疏松;压缩性骨折;老年人 　　Percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients 　　LIU Mingjian, CHEN Yuefeng 　　(Dongguan Shipai Hospital, Dongguan 523330 Guangdong;2. Miluo Peoples Hospital, Miluo 414400, China) 　　[ABSTRACT] Objective: To observe the clinical efficacy of percutaneous vertebroplasty for osteoporotic vertebral compression fractures in elderly patients. Methods: Thirty six vertebral bodies in 22 patients of osteoporotic compression fractures with back pain underwent vertebroplasty by unilateral transpedicular proach under the guidance of xray. Follow up ranging from 3 to 24 months were conducted to observe the therapeutic effects. Results: Vertebroplasty was successful in all the 28 cases and an average of 3.5 mL PMMA (ranging from 2～6 mL) were injected into each vertebral body. The follow up showed pain complete remission (CR) in 22 patients and partial remission (PR) in 6 cases, no deteriorism or recurrence of back pain, or compression of vertebral body were observed. Conclusions: Vertebroplasty is a safe, effective and minimally invasive treatment for osteoporotic compression fractures patients who show no response to conservative therapy. 　　[KEY WORDS] Vertebroplasty; Osteoporosis; Compression fracture; Elderly patient 　　椎体压缩性骨折(vertebral compression fractures, VCF)是临床上老年骨质疏松症患者最常见的并发症之一，严重影响患者的生活质量。既往对老年骨质疏松所致的椎体压缩性骨折多行保守治疗，主要是卧床休息及对症处理，病程长、并发症多、生活质量下降[1]。经皮椎体成形术(percutaneous vertebroplaty, PVP)是在影像介导下经皮向压缩骨折的椎体内注入骨水泥，以达到增强骨折椎体的稳定性，减轻甚至解除患者痛苦的目的，为老年骨质疏松性脊柱压缩骨折的治疗开辟了新途径。2006 年 7 月～ 2010 年 1月采用 PVP治疗28例(36个椎体)老年骨质疏