椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折

Treatment of Osteoporotic Vertebra Compressive Fractures in the over 80-year-old Patients with Percutaneous Kyphoplasty

目的探讨单一球囊扩张经皮椎体后凸成形术治疗80岁以上老年骨质疏松性椎体压缩骨折的疗效及安全性。方法回顾分析高龄(80岁及其以上)老年骨质疏松性椎体压缩骨折患者15例,男性3例,女性12例,平均年龄(82.2±1.9)岁。共45个椎体,均为骨质疏松性脊柱压缩骨折,压缩骨折椎体后壁均完整。全部在C型臂X线机引导下行单侧入路、单一球囊椎体后凸成形术。结果患者平均能在术后第2天下床行走,未发现严重手术并发症。椎体前缘、中部及后缘平均高度分别由术前的(2.17±0.82)cm、(1.75±0.66)cm、(2.95±0.43)cm增至术后的(2.40±0.73)cm、(2.11±0.51)cm、(3.00±0.45)cm,椎体前缘、中部高度差异有显著统计学意义(P<0.01);术后48 h患者胸腰背痛均有缓解,术前、术后48 hVAS评分比较差异有显著统计学意义(P<0.01)。结论应用椎体后凸成形术治疗高龄骨质疏松性椎体压缩骨折,能够安全、有效地改善骨折椎体高度,明显缓解疼痛,早期下床活动。

Objective To evaluate the efficiency and safety of percutaneous kyphoplasty in treating osteoporotic vertebra compressive fractures in the elderly（≥80 years）with one balloon. Methods 15 cases were retrospectively reviewed（3 males, 12 females）,and all with well intact posterior wall of vertebral body. 45 vertebral bodies were treated by percutaneous kyphoplasty with one balloon under＂C＂armed imaging guiding by an unipedicular approach. Results All the procedures of 15 patients were successful without any complication. The mean height of the anterior, media and posterior vertebral bodies was（2. 17±0. 82） cm, （1.75±0. 66） cm, （2.95±0.43） cm preoperatively and （2.40±0.73） cm,（2.11±0.51） cm, （3.00±0.45） cm postoperatively（P〈0. 01）. The VAS of pre and post-operation were declined significantly after the treatment （P〈0. 01）. Conclusion Percutaneous kyphoplasty for senior people （≥80 year） with osteoporotic vertebra compressive fractures via an unipedicular approach is safe and effective, which can significantly improve the hight of the vertebral bodies and symptoms.