单侧经皮椎体后凸成形术治疗老年性椎体压缩性骨折

Unilateral percutaneous kyphoplasty for vertebral compression fractures in elderly patients

目的:探讨经单侧椎弓根经皮椎体后凸成形术治疗老年性椎体压缩骨折的临床效果。方法:2007年7月～2008年2月12例共13个椎体老年性压缩骨折患者经单侧椎弓根行经皮椎体后凸成形术,其中男4例,女8例;年龄62～81岁,平均(71.3±5.91)岁。患者均有腰背部疼痛,其中11例为单椎体,1例为两椎体,骨折部位T10～L2。观察患者术前、术后影像学改变,疼痛改变情况,比较Oswestry功能障碍指数变化。结果:随访9～16个月,平均(12±2.34)个月,术后患者腰痛均明显缓解,术后恢复受伤前的生活,无并发症发生。术前椎体前缘高度为(20.0±2.36)mm,术后为(24.21±1.45mm)(P<0.01),末次随访为(23.46±1.26)mm;术前VAS评分为(7.25±1.29)分,术后为(1.67±1.23)分(P<0.01),末次随访为(1.83±0.83)分(P<0.01);术前ODI为(76.67±11.16)%,术后ODI为(15.95±6.50)%(P<0.01),末次随访为(13.81±4.69)%(P<0.01)。结论:单侧椎弓根经皮椎体后凸成形术可有效恢复骨折椎体的高度,迅速缓解疼痛,改善患者的生活质量。

Objective： To examine the clinical and radiographic results of percutaneous kyphoplasty for vertebral compression fracture in elderly patients via unilateral pedicle of vertebral arch. Methods：Twelve elderly patients with vertebral compressive fractures underwent percutaneous kyphoplasty during July 2007 through Feb 2008, of whom 4 were males and 8, females, aged from 62 to 81 with a mean age of （ 71.3±5.91 ） years. The patients were characterized by lumbar and back pain and the fractures f ranged from the level of T10 to L2. Single vertebral fractures were found in 11 cases and 1 of double. The involved factors were examined with regard to the radiographic findings, pain relief and Oswestry disability index （ODI） before and after operation. Results： The follow-up, ranging from 9 to 16 months with an average of 12±2.34, revealed that all patients relieved from the pain and recovered to normal life, with no occurrence of complications. The height of anterior column of the vertebrae increased from （ 20.0 ± 2.36 ） mm to （ 24.21 ± 1.45 ）mm as compared with pre-operation [ （23.46 ± 1.26） mm at final follow-up ] （ P 〈 0.01 ）. VAS score improved from 7.25 ± 1.29 to 1.67 ± 1.23 before and after operation, with 1.83 ±0.83 by the last follow -up （P 〈0.01）, and ODI was （76.67 ± 11.16） % before the procedure to （ 15.95± 6.50） % after op- eration, with（ 13.81 ± 4.69 ） % by final follow-up （ P 〈 0.01 ）. Conclusion ： Pereutaneous kyphoplasty via an unilateral pedicle of vertebral arch may be effective in restoration of the height of the compressed vertebrae, early pain relief and improvement of the patients＇life.