Catheter fabric椎体后凸成形术的初步临床应用

Primary clinical efficacy of catheter fabric kyphoplasty

目的探讨Catheter fabric椎体后凸成形术的初步临床应用效果。方法2007年12月至2008年3月6例不同病因的椎体骨折患者接受Catheter fabric椎体后凸成形术治疗，其中男1例，女5例；平均73．2岁（54～82岁），4例为骨质疏松性椎体骨折，1例为胃癌术后椎体转移，1例为多发性骨髓瘤。6例患者共有10个骨折椎体，其中T5 1椎，T101椎，T112椎，T12 4椎，L1 2椎。测量术前、术后2d及末次随访时X线片椎体前缘高度变化；术后CT扫描判断骨水泥在椎体内的分布；采用视觉模拟法（VAS）评分及Oswestry功能障碍指数（ODI）评分综合评估手术疗效。结果随访12～21个月，平均16．3个月，伤椎前缘高度比值由术前平均（44．5±3．1）％恢复至术后（72．7±2．5）％，差异有统计学意义（P〈0．05），随访时为（71．4±2．1）％，与术后比较差异无统计学意义（P〉0．05）。VAS及ODI评分术前分别为9．1±1．7、87．3±12．7，术后分别为2．3±0．6、30．4±7．9，差异均有统计学意义（P〈0．05）；随访时分别为2．1±0．3、29．9±6．7，与术后比较差异均无统计学意义（P〉0．05）。骨水泥在椎体内分布均匀，无渗漏；无椎体再骨折。结论Catheter fabric椎体后凸成形术安全，近期疗效满意，可用于不同病因的椎体骨折。

Objective To explore the primary clinical efficacy of catheter fabric kyphoplasty （CFKP） for vertebral fractures. Methods From December 2007 to March 2008, CFKP was performed for one male and 5 female patients with vertebral fractures caused by different diseases. Four patients had osteoporotic vertebral compression fractures, one had vertebral metastasis following gastric cancer and one had multiple myeloma. The anterior vertebral height was measured before operation, 2 days after operation and at the final follow-up. CT examination was conducted postoperatively to determine the distribution of cement. Visual Analog Scale （VAS） and the Oswestry Disability Index （ODI） were chosen to evaluate pain status and functional activity. Results The mean follow-up was 16.3 months （range, 12 to 21 months）. The anterior vertebral height of the fractured vertebra was restored averagely from preoperative （44.5 ± 3.1 ）% to postoperative （72.7 ±2. 5）% and to the follow-up （71.4 ±2.1）%. There was a significant improvement between the preoperative and postoperative values （ P 〈 0.05） but no difference between the postoperative and final follow-up values （ P 〉 0. 05）. The VAS was 9. 1 ± 1.7 preoperatively, 2.3 ± 0. 6 postoperatively, and 2. 1 ± 0.3 at the final follow-up; the ODI was 87.3 ± 12.7 preoperatively, 30.4 ±7.9 postoperatively, and 29.9 ± 6.7 at the final follow-up. There were statistically significant improvements in VAS and ODI between the post-operative assessment and the pre-operative assessment （ P 〈 0. 05）, but no statistically significant differences between the postoperative and the final follow-up values （ P 〉 0.05 ）. Conclusion CFKP is a safe and effective procedure for osteoporotic and osteolytic vertebral fractures.