椎体后凸成形术治疗老年人骨质疏松性脊柱骨折疗效观察

Percutaneous puncture kyphoplasty in the treatment of elderly patients with osteoporotic vertebral compression fracture： a report of 23 cases

目的探讨经皮球囊扩张椎体后凸成形术（PKP）治疗老年人骨质疏松性脊柱压缩性骨折的疗效与安全性。方法对23例34椎行PKP，术前及术后3d进行疼痛视觉评分（visual analogue scale，VAS）和活动能力评分；随访期间观察患者疼痛缓解及生活能力状况，并分析骨水泥渗漏、邻椎骨折等并发症。结果手术全部成功，术后早期疼痛明显缓解，VAS评分术后3d（2．5±0．6）分较术前（7．5±0．7）分明显下降（t=23．8，P〈0．01）；活动能力评分术后3d（1．2±0．4）分较术前（2．4±0．6）分明显改善（t=13．4，P〈0．01）；经平均15．6个月随访，1例患者出院后因心脏病发作死亡，4例发生周围椎体骨折，无一例发生骨水泥渗漏。结论PKP具有微创特点，能迅速缓解疼痛，对老年人骨质疏松性脊柱骨折治疗的效果满意。

Objective To research the efficacy and safety of pereutaneous puncture kyphoplasty in the treatment of elderly osteoporotic vertebral fracture. Methods PkP were performed in 23 patients （ 34 vertebrae）, visual analogue scale （VAS） and mobility were evaluated before and three days after operation. Relief of back pain, recovery of mobility and complications（ cement leakage, adjacent vertebral body fractures,etc） were observed in the follow up. Results All patients were successfully performed with immediate relief of their back pain. The mean scores of VAS and mobility 3 days after operation were respectively decreased from（7.5 ± 0. 7 ）, （2. 4 ± 0. 6） preoperative to（2.5 ± 0. 6）, （ 1.2 ±0. 4） at 3 day after operation with a significant difference（t =23. 8,13. 4,P 〈0. 01 ）. The patients were followed up for average 15.6 months with satisfactory therapeutic effect,one patient died of heart disease two months after discharge, around vertebral fracture occurred in 4 patients, they were no cement leakage in all the patients. Concluslon PKP is one of the new minimally invasive technologies, which can rapidly relieve pain. PKP is an ideal method in treating elderly osteoporotic spinal compression fractures.