经皮后凸成形术治疗陈旧不愈合骨质疏松性椎体压缩性骨折

Percutaneous kyphoplasty in treatment of old nonunion osteoporotic vertebral compression fractures

目的探讨经皮后凸成形术治疗老年陈旧不愈合骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床效果。方法 2005年3月～2008年1月,38例老年陈旧不愈合OVCF患者(41个椎体)接受经皮后凸成形术。患者术前行站立位、动力位X线,CT,MRI检查。比较术前、术后目测类比疼痛评分(visual analoguescale,VAS),Oswestry功能障碍指数(Oswestry disabiliby index,ODI),椎体前缘、中线和后缘高度。结果术后平均随访15.2个月。VAS评分从术前7.9分下降至术后3.0分,ODI从术前65.3%下降至术后37.2%,椎体前缘、中线高度较术前分别恢复8.3 mm、6.2 mm,椎体后缘高度无明显变化。结论椎体后凸成形术是治疗老年陈旧不愈合OVCF的一种行之有效的方法。

Objective To discuss the clinical effect of percutaneous kyphoplasty（PKP） in treatment of old nonunion osteoporosis vertebral compression fractures（OVCF）.Methods From March 2005 to January 2008,38 cases（41 vertebrae） of symptomatic old nonunion OVCF were treated by PKP.Before operation,all the patients were examined by standing anteroposterior and lateral roentgenograph,CT scan and MRI.The pain level of each patient was assessed before and after the operation,using visual analogue scale（VAS） and Oswestry disability index（ODI）.The anterior vertebral body height,middle line vertebral body height and posterior vertebral body height before and after the operation were also measured.Results After the follow-up of a mean time of 15.2 months,postoperative average VAS score reduced from 7.9 to 3.0,and ODI reduced from 65.3% to 37.2%.The mean corrected anterior vertebral body height and middle line vertebral body height were 8.3 mm and 6.2 mm,respectively.Conclusion PKP is a reasonable procedure for the treatment of old nonunion OVCF.