经皮穿刺椎体成型术治疗老年性骨质疏松性椎体压缩骨折的疗效分析

Effect of perutaneous vertebroplasty in treatment of osteoporotic vertebral compression fractures in elder people

目的探讨经皮穿刺椎体成型术(perutaneous vertebroplasty,PVP)治疗老年性骨质疏松性椎体压缩骨折(VCF)的近期疗效。方法应用经皮穿刺椎体成型术治疗23例老年性骨质疏松椎体压缩骨折,共28个椎体。CT检查明确病椎椎体后壁的完整,应用C型臂X光机手术前和手术中定位,采用经单侧椎弓根手术入路,平均骨水泥注射量2～4ml左右。术前后应用国际通用术前疼痛目测分级(VAS)评分。结果23例患者28个椎体操作全部成功,成功率100%。术后3d疼痛开始缓解15例;术后1个月疼痛完全缓解18例(1823),显著缓解5例(523)。VAS评分平均2.01分,与术前比较有显著性差异(P<0.001)。术后1年随访,患者完全满意16例,满意5例,较满意2例。术后1年疼痛VAS评分平均2.13分;与术后1个月比较无显著性差异(P>0.05)。结论PVP是一种治疗骨质疏松椎体骨折的微创手术,能有效缓解骨质疏松性椎体骨折引起的疼痛,维持椎体稳定性,是一种有价值治疗骨质疏松性骨折的方法。

Objective To assess the immediate effect of percutaneous vertebroplasty （PVP） in pain relief and mobility improvement in elderly patients with osteoporotic vertebral compression fractures （VCF）. Methods Twenty-eight vertebraes（ from 23 patients） underwent percutaneous injections of polymethylmethacrylate （ 2 - 4 ml） with unilateral transpedicular approach guided by CT. Visual analog scale（VAS） score was assessed before and after PVP. Results All PVP performed were successful. Pain was relieved 3 days after the procedure in 15 cases （15/ 23）, completely relieved one month after PVP in 18 cases（18/23） and partial relieved in 5 cases（5/23）. The VAS score showed significant reduction from pre-to post-PVP（ P 〈 0.001 ）. One year after PVP, 16 cases were fully satisfied. No significant difference was shown in the VAS score between that at 1 month and 1 year after PVP（ P 〉 0.05）. Conclusions PVP is a safe and effective microinvasive procedure in management of osteoporotic VCF through pain relieving and vertebrae strengthening.