影像下经皮椎体成型术治疗骨质疏松性腰椎压缩骨折临床探究.docVIP

影像下经皮椎体成型术治疗骨质疏松性腰椎压缩骨折临床探究[摘要]目的探讨影像下经皮椎体成形术治疗骨质疏松性腰椎压缩骨折的疗效与安全性。方法C型臂X线透视引导下行经皮椎体成型术治疗31例骨质疏松性腰椎压缩骨折患者（共38个椎体），密切观察术中可能产生的并发症，采用视觉模拟疼痛评分法评定患者术前与术后的疼痛程度；并采用X线摄片随访，随访时间为3～10月，平均6.6月。结果5例患者术中发生骨水泥渗漏（共计6个椎体），渗漏率为16.1%，以椎体计算，渗漏率为15.8%。2例患者出现短暂腹部烧灼感或胀痛，无1例出现严重并发症。所有患者术后3天内疼痛明显减轻或消失(P＜0.001)。术后4月，疼痛复发者1例。3例(9.8%)在术后4～10个月病变椎体出现轻度塌陷,但无疼痛复发；12例（38.7%）出现邻近椎体部分塌陷，但没有超过椎体高度的25%且无疼痛症状，未做处理。结论经皮椎体成形术可安全有效地缓解骨质疏松性腰椎压缩骨折引起的疼痛。 关键词：经皮椎体成形术骨质疏松症疼痛腰椎骨折 Objective: The aim of this paper was to assess the efficacy and safety of percutaneous vertebroplasty with image guided for osteoporotic lumbar vertebral compression fractures .Methods: 31 patients suffering from 38 osteoporotic lumbar vertebral compression fractures were treated with C-arm X-ray image guided percutaneous vertebroplasty. And the intraoperative complications were close monitored. The degree of pre- and post-operative pain were assessed by Visual Analogue Score (VAS). Then postoperative follow-up with X-ray image assessment ranged 3 to 10 (average 6.6)months.Results: In 5 patients 6 VBs were classified as cement leakage. 2 patients showed the temporary abdominal burning or soreness sensation. And no serious complications occurred after treatment. All patients achieved a good pain control 3 days post-operation(P＜0.001), but one case experienced recurrent pain at 4 months postoperation. In 3 patients(9.8%) were classified as adjacent-level fractures, and in 12 patients were classified as nonadjacent-level fractures, whose height ratios were less than 25% of vertebral height. All of which were untreated because of no pain recurrence.Conclusions: Percutaneous Vertebroplasty (PVP) is an effective and safe medical treatment for osteoporotic lumbar vertebral compression fractures pain. Keywords: percutaneous vertebroplastyosteoporosispainlumbar vertebral fractures 中图分类号：R683 文献标识码：B 文章编号：1004-7484（2011）11-0045-03 经皮椎体成形术（percutaneous vertebroplasty，PVP）是1987年由Galibert等首先应用于治疗颈椎侵袭性血管瘤一种脊柱微创手术，后被逐步应用于治疗骨质疏松症椎体压