经皮椎体成形术治疗疼痛性骨质疏松性胸腰椎压缩骨折

Percutaneous Vertebroplasty for Treatment of Painful Osteoporotic Thoracolumbar Vertebral Compression Fracture

目的 观察经皮椎体成形术 (PVP)治疗疼痛性骨质疏松性胸腰椎压缩骨折的初步临床疗效并分析其止痛机制。方法 自 2 0 0 3年 1月～ 2 0 0 3年 11月 ,使用自固化磷酸钙人工骨 (CPC)为充填材料 ,在透视监视下 ,经单侧或双侧椎弓根穿刺行椎体成形术治疗 2 3例 31个骨质疏松性胸腰椎压缩骨折的椎体。结果 CPC平均充填量胸椎 3 1ml,腰椎 4 0ml;术中CPC渗漏者 4例 4个椎体 ,但无 1例出现严重并发症。术后根据Huskisson目测疼痛评分法(VAS)评定 ,并经 3～ 10个月 (平均 6 6个月 )的随访 ,术后所有患者疼痛明显减轻或消失 (P <0 0 1)。结论 PVP可安全有效地缓解骨质疏松性胸腰椎压缩骨折引起的疼痛。

Objective To investigate the clinical effectiveness of percutaneous vertebroplasty (PVP) in the treatment of painful osteoporotic thoracolumbar vertebral compression fracture. Methods From Jan. 2003 to Nov. 2003, under C-arm fluoroscopy monitoring, 31 consecutive PVP procedures through unilateral or bilateral verterbral pedicles with autosolidification calcium phosphate cement (CPC) were performed on 23 patients with painful osteoporotic thoracolumbar vertebral compression fracture. Results The average injection dose of CPC was 3.1 ml for thoracic and 4.1 ml for lumbar vertebrae. Cement leakage occurred during the procedure at 4 levels. All patients had successful intervention and marked or complete pain relief assessed by the visual analogue scale (VAS) (P<0.01), and were followed up with the range 3-10 months. There was no severe complication related to this treatment.Conclusion PVP is safe and effective, and has a useful role in the treatment of painful osteoporotic vertebral compression fractures.