CT引导经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的疗效分析

Effect analysis of CT-guided percutaneous kyphoplasty for osteoporotic verterbral compression fracture

目的探讨经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的临床疗效。方法自2007年10月至2009年1月对30例骨质疏松性椎体压缩性骨折患者采用经皮椎体后凸成形术(PKP)治疗,通过比较手术前后及术后6个月随访时(即末次随访)疼痛程度(VAS评分)、日常活动能力、止痛药使用情况及椎体前缘高度的变化,以评价手术效果。结果所有患者手术均获得成功,术后患者疼痛明显缓解,术前VAS评分(8.52±1.13),术后为(2.48±1.04),末次随访时为(2.73±1.08);止痛药使用评分术前为(2.86±0.82),术后为(0.63±0.21),末次随访时为(0.51±0.22);活动能力评分术前为(2.74±0.68),术后为(1.05±0.34),末次随访时为(1.12±0.27);椎体前缘高度术前为(13.98±4.62),术后为(22.56±4.34),末次随访时为(22.03±4.93)。随访六个月无并发症发生。各指标术后及末次随访时与术前比较有显著性差异(P<0.05),而末次随访时与术后第二天比较无显著性差异(P>0.05)。结论应用经皮椎体后凸成形术治疗骨质疏松性椎体压缩性骨折能够迅速缓解疼痛,恢复伤椎高度,矫正后凸畸形,改善生活质量,是一种安全有效的微创治疗方法。

Aim To disscuss the efficacy of pereutaneous kyphoplasty（PKP） on the treatment of osteoporotic verteberal compression fracture. Methods 36 vertebraes in 30 patients suffered osteoporotic vertebral compression fracture were treated by PKP with the guide of CT. Clinical effects were evaluated by observing the changes of visual analogues scales, daily life function, painkillers intake and the height of anterior of the compression vertebrae. Results All patients were punctured and operated successfully. VAS score improved from （ 8.52 ± 1.13 ） to （ 2.48 ± 1.04 ） before and after operation, and was （ 2.73 ± 1.08 ） at final follow-up. The score of taking painkillers improved from （ 2.86 ± 0.82 ） to （ 0.63 ± 0.21 ） before and after operation, and was （ 0.51± 0.22 ） at final follow-up. The score of daily life function improved from （ 2.74 ± 0.68 ） to （ 1.05 ±0.34 ）, and was （ 1.12± 0.27 ） at final follow-up, the height of anterior of the compression vertebrae improved from（ 13.98 ±4.62） mm to（22.56 ±4.34） mm,and was（22.03 ±4.93）mm at final follow-up. The indicators of postoperative and final follow-up had a significant difference compared with preoperative （ P 〈 0.05 ）, but there was no significant difference between postoperative and final follow-up（ P 〉 0.05 ）. No severe sideeffect was observed after operation and follow-up. Conclusion Percutaneous kyphoplasty can relieve pain, enhance the height of the compressed vertebrae, correct the abnormality of posterior bulge of vertebrals and improve the quality of the patients＇ life. It is a safe, effective and minimal invasive way to treat osteoporotic verteberal compression fracture.