经双侧椎弓根椎体内植骨治疗骨质疏松椎体压缩性骨折

Core decompression through bilateral vertebral pedicles with bone graft treatment of osteoporotic vertebral compressive fracture

目的观察经椎弓根椎体内植骨术治疗骨质疏松椎体压缩性骨折的临床疗效。方法88例130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骨术。术前、术后行视觉模拟疼痛评分(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20min。所有患者疼痛明显缓解。VAS术前为(9.1±0.9)分,术后3d(3.2±0.5)分,术后7d(2.5±0.5)分,术后2个月(2.7±0.4)分。术前、术后差异有极显著性意义(P<0.05)。患者睡眠、运动明显改善,随访8～18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骨术是一种有效的治疗骨质疏松症椎体压缩性骨折的方法。

Objective To investigate the clinical effectiveness of core decompression through bilateral vertebral pedicles with bone graft in the treatment of painful osteoporotic ghoracolumbar compressive fractures. Methods Eighty-eight patients with 130 painful osteoporotie thoracolumbar compressive fractures underwent core decompression through bilatelal vertebral pedicles with bone graft. Pain visual-analog scale（VAS） scores were recorded before and after operation. During follow-up time, complications were observed. Results The operations in this series were performed successfully. The average operating time per vertebral was 20 minutes. All patients reported significant pain relief after operation. The VAS scores were （9. 1 ± 0.9） preoperatively, （3.2 ± 0. 5）three days postoperatively, （2.5 ± 0.5） seven days postoperatively and （2. 7 ± 0. 4） two months postoperatively. There were statistically differences between preoperative and postoperative pain scores （P〈0. 01）. The quality of their sleep and motion were significantly improved. Follow-up time ranged from 8 to 18 months, with an average time of 9.8 months. There was no aggravation of pain and no significant loss of the vertebral height with the operation at follow-up review. Conclusion Core decompression through bilatelal vertebral pedicles with bone graft is an effective procedure for patients with painful osteoporotic thoracolumbar compressive fractures.