球囊扩张椎体后凸成形术治疗老年骨质疏松性椎体骨折

Transpedicular Kyphoplasty for Treatment of Senile Osteoporotic Vertebral Fracture

目的探讨球囊扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的临床疗效。方法采用球囊扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折25例30椎,其中T81椎,T113椎,T1212椎,L111椎,L22椎,L31椎。结果全部病例均顺利完成手术,无症状性并发症发生。所有患者术后疼痛明显减轻,疼痛视觉模拟数字评分(VAS)由术前的平均8.4分下降到术后的2.2分。平均椎体前缘高度恢复(55.3±34.2)%,中部恢复(61.5±35.1)%,后缘恢复(40.1±32.3)%。手术后Cobb角平均改善9.6°(0～30°)平均灌注骨水泥5.6 ml(2.5～9.0 ml)。除1个椎体前缘有少许未引起临床症状的骨水泥渗漏外,其余椎体均无明显骨水泥渗漏。随访2～18个月,平均9.5个月,未发现与手术有关的并发症。结论球囊扩张椎体后凸成形术治疗骨质疏松性椎体骨折可有效地缓解疼痛,恢复椎体高度,改善矢状面排列,疗效满意。

Objective To investigate the clinical results of transpedicular kyphoplasty for the treatment of senile osteoporotic vertebral fracture. Methods Percutaneous transpedieular kyphoplasty with single balloon was performed for the treatment of osteoporotic vertebral fracture in 30 vertebrae of 25 senile patients. The compression fracture was involed respectively in Ts in 1, T11 in 3, Tl2 in 12, L1 in 11, L2 in 2 and L3 in 1 vertebra（ e）. Results All the patients tolerated the procedure well with immediate relief oi back pain after kyphoplasty. No symptomatic comphcations were found. The mean visual ache simulation （VAS） score decreased singnificantly from preoperative 8.4 to postoperative 2.2. The mean vertebral body height restoration was 55.3% ± 34.2% （ anterior border） , 61.5%±35.1% （ middle portion） , and 40. 1%±32.3% （ posterior border） , respectively. The average correction of the cobb＇ s angle reached 9.6 degrees. No cement leakage was found under X-ray in all the patients, except one with less cement leakage at the anterior vertebral edge and without clinical symptom. All the patients were available during the follow-up of 10.5 months （2 - 18 months）. Conclusion Transpedicular kyphoplasty with single balloon can ,ot only provide an effective relief from pain and a restoration of vertebral heigh, but also improve the sagittal alignment significantly. Its clinical outcome is satisfactory.