经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折.docVIP

经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折 【摘要】 探讨经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折的临床疗效及并发症。［方法］本组18例27椎， 对14例23椎行经皮椎体成形术 (percutaneous vertebroplasty,PVP)，4例4椎行经皮椎体后凸成形术(percutaneous kyphoplasty，PKP)，术前及术后3 d进行疼痛视觉类比评分(visual analogue scale,VAS)和活动能力评分；随访期间观察患者疼痛缓解及生活能力状况，并分析骨水泥渗漏、邻椎骨折等并发症。［结果］手术全部成功，术后早期疼痛明显缓解，VAS评分术后3d (2. 5±0. 6)较术前(7. 5±0. 7)明显下降(Plt;0. 01)；活动能力评分术后3 d(1. 2±0. 4)较术前(2. 4±0. 6)明显改善(Plt;0. 01)。经平均15. 6个月随访，1例患者出院后因并发心脏病死亡； 4例发生周围椎体骨折；3例发生骨水泥渗漏。患者对治疗效果满意。［结论］只要严格掌握手术适应证，术中精心操作，经皮椎体成形术及后凸成形术为老年骨质疏松性脊柱压缩骨折治疗的理想选择，但与手术相关的并发症要引起重视。 【关键词】 骨质疏松 脊柱骨折 经皮椎体成形术 后凸成形术 Abstract：［Objective］To study the effect and complications of percutaneous vertebroplasty and kyphoplasty in treating osteoporotic spinal compression fractures．［Method］Eighteen patients with twentyseven vertebras in group，PVP (percutaneous vertebroplasty)were performed in fourteen patients(twentythree vertebras)，PKP(percutaneous kyphoplasty)were performed in four patients (four vertebras)，VAS(Visual analogue scale) and mobility were evaluated 3 days before and after operation．Relief of　back pain、recovery of living ability and complications were observed in the followup．［Result］All patients were operated on successfully and their back pain relieved immediately after operation，VAS was distinctly decreased from(7.5±0.7)pre-operation to (2.5±0.6)at 3 day after operation with a significant difference(Plt;0.01)； Scale of patient，s mobility was distinctly decreased from(2.4±0.6) preoperation to (1.2±0.4) at 3 day after operation with a significant difference(Plt;0.01)．During average 15.6 months followup， one patient died because of heart disease after two months，neighbor vertebral fracture occurred in four patients，bone cement leakage in three patients． All patients got satisfactory clinical effect．［Conclusion］Under strict selection and elaborate operation, PVP and PKP are ideal methods in treating osteoporotic spinal compression fractures，but the complications relevant