椎体后凸成形术治疗高龄骨质疏松性胸腰椎压缩骨折

CLINICAL OBSERVATION ON KYPHOPLASTY TO CURE OLDER-AGE OSTEOPOROSIS COMPRESSION FRACTURE OF THORACOLUMBAR CENTRA

目的:探讨球囊扩张椎体后凸成形术(Kyphoplasty)治疗高龄老年骨质疏松性胸腰椎压缩性骨折的疗效及安全性。方法:选取高龄(>80岁)老年骨质疏松性胸腰椎压缩性骨折患者15例,在局部麻醉下,经皮双侧椎弓根穿刺建立工作通道,放置可扩张球囊于伤椎内塌陷终板下方,扩张球囊抬升终板恢复伤椎高度,在持续透视监控下注入骨水泥强化椎体,比较椎体后凸成形手术前后伤椎复位情况,患者背痛的缓解程度以及活动恢复情况。结果:患者均能在术后次日下床行走,未发现手术并发症,手术前椎前部、中部高度,脊柱后凸畸形Cobb角与术后相应数据配对比较,差异有统计学意义(P<0.05);术后24小时患者胸腰背痛均明显缓解,手术前后背痛比较差异有统计学意义(P<0.05)。结论:球囊扩张椎体后凸成形术在高龄骨质疏松性胸腰椎压缩性骨折的治疗上,能够安全微创地复位固定伤椎,止痛作用确切,可实现早期活动。

Objective:To explore the curative effect and safety of Kyphoplasty on curing older-age osteoporosis compression fracture of thora-columbar centra.Methods:15 cases of patients with older-age osteoporosis compression fracture of thoracolumbar centra(>80 years),with anesthesia,passage for treatment were built on both sides of lateral mass of vertebrae,sacculus proprius were layed in the cave of injuried vertebra end plate,and height of injuried vertebra were recovered by sacculus proprius ascending,bone cement were added to rebuild body of vertebra under monitoring of continuous perspective.Recovery informations of injuried vertebra pre-and post-operation,anesis degrees of patients' backache and recovery of activity were observed and compared.Result:They all could get out of bed for activity next day post-operation,and there had no complication of operation.on the comparison of such items as height of prevertebral part and central region,degrees of cobb' s angle pre-and post-operation,there had statistical significance on discrepancy(P< 0.05).24 hours post-operation backache of patients had obviously relieved,and there had statistical significance on discrepancy of backache comparison pre-and post-operation(P< 0.05).Conclusion:For the therapy of older-age osteoporosis compression fracture of thoracic waist lumbars,the method above could reduce and fix injuried vertebra safely and minihurtly,and had obvious analgesic effect,patients could get early mobilization.