经单侧椎弓根入路椎体成形治疗胸腰椎压缩骨折

Treatment of Osteoporotic Thoracolumbar Compressive Fractures with Percutaneous Vertebroplasty by Unilateral Pedicle of Vertebral Arch Approach

目的探讨经单侧椎弓根入路椎体成形术治疗胸腰椎压缩骨折的临床效果。方法2005年6月至2007年3月对62例胸腰椎压缩性骨折共90个椎体行经单侧椎弓根入路椎体成形术．经C臂X线机透视定位引导下进行穿刺，将调制成糊状的骨水泥用螺旋加压注射装置匀速缓慢注入病变椎体。结果共治疗62例，90个椎体，其中单节段40例。双节段16例。三节段6例。随访3～18个月（平均12个月）。止痛效果依据目测疼痛评分法进行评价．术后止痛效果达98．4％（61／62）．术后立即止痛35例．占56．5％，1d后止痛15例，占24．2％，3d后止痛11例，占17．7％，未能止痛1例．占1．6％。本组无一例发生需治疗干预的并发症。结论经皮椎体成形术具有显著的止痛效果．是治疗骨质疏松性胸腰椎压缩骨折安全有效的微创治疗方法。

Objective To study the clinical effect of percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar compressive fractures by unilateral pedicle of vertebral arch approach. Methods Since June 2005 to March 2007,90 vertebrae（62 patients） with osteoporotic compressive fractures underwent procedures by C-arm fluoroscopy guidance,cement was modulated into paste and injected slowly into the fractured vertebrae by helical compression injection device. Results 62 patients with 90 fractured vertebrae enrolled in the study,40 cases with single vertebral, 16 cases with double vertebrae and 6 cases with 3 vertebrae. Postoperative follow-up period was 3 - 18 months（mean, 12 months）. The Visual Analog Seale（VAS） was used to assess the effects before and after PVP. 98. 4%（61/62） of patients had substantial pain relief. The pain relief occurred immediately in 56.5%（35 cases） of patients. 15 cases （24.2 % ） in 1 day and 11 cases （ 17.7 % ） in 3 days. One patient failed to obtain pain relief. No serious complication was noted. Conclusion percutaneous vertebroplastv can provide significant pain reduction in the treatment of osteoporotic tboracolumbar compressive fractures.prove to be a safe and effective minimally invasive surgery.