Sky椎体成形器治疗老年创伤性椎体骨折

The Sky bone expander system in treatment of senile traumatic fractures of vertebral body

目的探讨Sky膨胀式椎体成形器治疗老年创伤性椎体骨折的疗效和安全性。方法2004年8月～2006年2月，采用Sky膨胀式椎体成形器行经皮椎体后凸成形术治疗老年由创伤引起的脊柱压缩性骨折23例34椎。所有患者椎体后壁完整，术前均无脊髓和神经根受损的症状和体征。采用经皮穿刺单侧椎弓根置人Sky膨胀式椎体成形器使骨折塌陷椎体复位，用骨水泥进行充填。结果所有患者术后24h内疼痛症状明显缓解或消失，术后1d可下地行走，3d出院。术后第2天常规行X线复查，2例3个椎体出现骨水泥少许渗漏，未见神经压迫症状。手术前、后骨折椎体前缘的平均高度分别为（18．34±3．25）mm和（20．51±1．34）mm，差异有统计学意义（P〈0．05）；中线的平均高度分别为（14．40±2．56）mm和（19．66±1．28）rain，差异有统计学意义（P〈0．05）；后缘的平均高度分别为（23．78±1．89）mm和（24．57±2．03）mm，差异无统计学意义（P〉0．05），均提示伤椎前中部高度恢复明显。后凸畸形纠正范围13^o-26^o，平均19^o。23例随访17—36个月，平均24．3个月，未诉明显疼痛，X线片示椎体高度未见明显丢失。未出现严重并发症。患者术前、术后第3天、随访12个月时的平均VAS评分分别为7．9分、3．1分、2．8分，后两者与术前比较差异均有统计学意义（P〈0．05）。结论Sky膨胀式椎体成形器治疗性老年创伤性椎体压缩骨折，能迅速缓解疼痛，恢复椎体高度。

Objective To investigate the clinical efficacy of the Sky Bone Expander system in the percutaneous kyphoplasty for senile traumatic vertebral compression fractures. Methods From August 2004 to February 2006, 23 cases （34 vertebrae） of traumatic vertebral compression fractures underwent percutaneous kyphoplasty with sky bone expander system. During the operation, the uni-pedicle technique was applied and the expansion height was reduced with sky bone expander for bone cement injection. Patients were evaluated with Visual Analogue Scale （VAS）. The anterior, midline and posterior heights of the vertebral body and kyphosis angle were measured preoperatively and postoperatively. All the data were send to a paired-samples T test. Results Back pain was effectively relieved after the operation in all cases. Ex- tra-vertebral leakage of bone cement was observed in 2 cases （3 vertebrae） with no symptoms. The postoperative follow-ups ranged from 17 to 36 months, with an average of 24.3 months. Preoperatively, the anterior vertebral height was 18.34 ± 3.25 mm and the midline vertebral height 14.40 ± 2.56 mm, while the postoperative anterior and midline ones were 20. 51 ± 1.34 mm and 19. 66 ± 1.28 mm, respectively （ P 〈 0. 01）. The posterior vertebral height was 23.78 ± 1.89 mm preoperatively and 24. 57 ± 2. 03 mm postoperatively （ P 〉 0. 05） . The kyphotie angle was decreased 13^o-26^o （mean 19^o） . The VAS scores were 7. 9 points preoperatively, 3.1 points at day 3 and 2. 8 points in 6 months after operation （ P 〈 0. 05 ）. Conclusions Kyphoplasty using the Sky Bone Expander system is an effective and safe treatment for senile traumatic vertebral compression fracture. Sky bone expander system ean lead to significant pain relief, improve the kyphosis deformity and retain the vertebral height.