经椎弓根椎体内植入人工骨治疗多节段骨质疏松压缩性骨折

Core decompression through bilatelal vertebral pedicles with artificial bone for treatment of multiple-level osteoporotic vertebral compression fracture

目的:观察经椎弓根椎体内植入人工骨术治疗疼痛性骨质疏松症并胸腰椎多节段骨折的初步临床疗效。方法:102例314个骨质疏松症胸腰椎压缩性骨折椎体采用经双侧椎弓根钻孔椎体内减压并植入人工骨术。术前术后行疼痛视觉模拟评分(vasual analogue scale,VAS)并随访观察并发症情况。结果:全组均安全完成手术,平均每个椎体手术时间为12 min。所有患者疼痛明显缓解,VAS术前为(9.2±0.9)分,术后3 d(3.2±0.7)分,术后7d(2.5±0.5)分,术后3个月(2.7±0.6)分。术前、术后差异有显著性(P<0.01)。患者睡眠、运动明显改善,随访3～19个月(平均9.8月),疼痛无加重,所处理椎体高度无丢失。结论:经椎弓根椎体内植入人工骨术对多节段骨质疏松症椎体骨折是一种有效的治疗方法。

Objective： To investigate the clinical effectiveness of core decompression through bilatelal vertebral pedicles with artificial bone on the treatment of painful osteoporotic thoracolumbar multiple-level vertebral compression fractures. Methods： 102 patients with 314 painful osteoporotic thoraeolumbar multiple compression fractures underwent core decompression through bilatelal vertebral pedicles with artificial bone. Pain visual-analog scale （VAS） scores were recorded preoperatively and postoperatively. During follow-up time, the complications were explored. Results： The operations in this series were performed successfully. The average operating time per vertebral was about 12 minutes. All patients reported significant pain relief after operation. The VAS scores were 9.2±0.9 preoperatively, 3.2±0.7 three days postoperatively and 2.5±0.5 seven days postoperatively. There were statistic differences in pain scores preoperatively and postoperatively （P〈0.01）. The quality of sleep and motion of patients significantly improved. Follow-up time ranged from 3.0 to 19.0 months, with an average time of 9.8 months. No aggravation of pain and no significant loss of the vertebral height appeared during the follow-up time. Conclusions： Core decompression through bilatelal vertebral pedicles with artificial bone is an effective handle procedure for patients suffered from painful osteoporotic thoracolumbar multiple-level vertebral compressive fractures.