比较单侧及双侧椎体后凸成形术治疗骨质疏松压缩骨折.docVIP

比较单侧及双侧椎体后凸成形术治疗骨质疏松压缩骨折【摘要】 目的 回顾性比较单侧经皮球囊后凸成形术(PKP)与双侧经皮球囊椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效。方法 56例患者分为单侧PKP组31例与双侧PKP组25例,累及椎体90个。在X线监测下,对病椎行单侧球囊后凸成形术或双侧球囊后凸成形术。采用VAS评分、Oswestry功能障碍评价指数及测量椎体高度丢失率及恢复率对患者手术效果进行比较。结果 两组手术患者术后疼痛均缓解,患者随访6~21个月。两组术后VAS评分与Oswestry功能障碍指数比较无显著行差异。结论 单侧与双侧PKP术治疗老年骨质疏松脊柱压缩骨折均可获得满意疗效、术前可根据患者病情选择手术方法可取得良好疗效。 【关键词】comparative study of unilateral or bilateral Percutaneous kyphoplasty treat to osteoporotic compression fractures LIU En zhi,GUO Dong ming,YAN Han.Spine Surgery department of Guangzhou No.1 Peoples Hospital, Guangzhou 510180,China 【Abstract】 Objective To retreospectively compare the clinical outcome of unilateral or bilateral percutaneous kyphoplasty treatment of osteoporotic compression fractures vertebrae.Methods 56 patients were divided into 31 cases of unilateral PKP groupand 25 cases ofbilateral PKP group,involving a total of 90 vertebral fracture body.Underwent percutaneous kyphoplasty with unilateral or bilateralpercutaneous kyphoplasty.we used the Oswestry disability index(ODI)and visual analoguescale(VAS)and the clinical indexs to measure the clinicaloutcome.Results After surgerytwo groups of patientswere immediately release the pain.all patients were Follow up by 6~21 months.In postioperation,two groups of patients of 0 swestry and VAS score were improved andwere no significant difference.Conclusion Unilateral or bilateralpercutaneous kyphoplasty for painful osteoporotic vertebral body fractures is effective and safe. 【Key words】 Kyphoplasty; Vertebral compression fracture; Osteoporosis 经皮球囊扩张后凸成形术(KPK)用于治疗骨质疏松性椎体压缩骨折,笔者对2006年1月至2009年3月应用单侧PKP与双侧PKP治疗的患者的疗效进行回顾性分析,探讨之间差异。 1 资料与方法 1.1 一般资料 本组患者56例,男19例,女37例,年龄57~84岁,平均71.4岁。为疼痛性骨质疏松脊柱压缩骨折,病椎共90个(T?5~L?4)。临床无脊髓压迫征象。其中单侧PKP组31例,累及1个椎体15例,2个椎体8例,3个椎体5例,4个椎体3例,发生部位:T?5 2椎 ,T?6 2椎,T8 3椎,T10 4椎,T11 8椎,T12 19椎,L?1 14椎,L?2 3椎,L?3 2椎,L?4 1椎。双侧PKP组25例,累及单椎体18例,2个椎体7例;发生部位:T10 1椎,T11 2椎,T12 16椎,L?1 12椎,L?2 2椎,L?3 1椎。 1.2 手术方法 患者俯卧位,C臂X线机定位靶椎,体表标记穿刺点,常规消毒铺巾,1%利多卡因局麻至骨膜,X线