单侧入路PKP治疗老年胸腰椎骨质疏松性压缩骨折疗效观察

Clinical Efficacy of Percutaneous Kyphoplasty Through One Side Approach for Treating Thoracic and Lumbar Osteoporotic Vertebral Compression Fracture in Senile Patients

【目的】探讨单侧入路经皮球囊扩张椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗老年胸腰椎骨质疏松性压缩骨折的临床疗效。【方法12007年05月至2010年01月，使用单侧入路PKP技术治疗老年胸腰椎骨质疏松性压缩骨折2l例，并进行疗效观察。【结果】所有患者术后随访6～12个月（平均10．2个月），手术前、手术后1d、手术后3月测量伤椎前缘平均高度分别为（13．9±4．8）mm、（20．6±3．8）mm、（19．2±4．3）mm；伤椎中线平均高度分别为（12．2±3．9）mm、（16．5±3．2）mm、（15．9±3．6）mm；伤椎Cobb角分别为25．3°±5．8°、15．2°±4．2°、16．8°±4．0°；患者VAS疼痛评分分别为7．7±1．6分、2．6±1．2分、2．4±1．0分，经统计分析得出伤椎前缘和中线高度、伤椎Cobb角和VAs疼痛评分在手术前与术后1d、手术前与术后3月之间有统计学意义（P〈0．05），术后1d和术后3个月之间无统计学意义（P〉0．05）。【结论】单侧入路PKP方法具有微创、安全、疗效确切的优点，是治疗胸腰椎骨质疏松性压缩骨折的理想方法。

[Objective]To explore the clinical effidacy of percutaneous kyphoplasty（PKP） through one side approach for the treatment of thoracic and lumbar osteoporotic vertebral compression fracture in senile patients. [Methods]From May 2007 to January 2010, 21 patients with osteoporotie thoracic and lumbar vertebral compression fracture were treated by PKP technique through one side. The clinical efficacy was observed. [Results]The follow-up time were 6 - 12 months with the average of 10.2 months. The anterior vertebral height was 13.9±4.8mm, 20.6±3.8 mm and 19.2±4.3 mm, and the midline vertebral height was 12.2±3.9mm, 16.5±3.2mm and 15.9±3.6mm, and the Cobb angle was 25.3°±5.8°, 15.2°±4.2° and 16.8°± 4.0°, and the visual analogue scale（VAS） point was 7.7±1.6 points, 2.6±1.2 points and 2.4±1.0 points, respectively in preoperation, one day and three months after operation. All index had statistical significance between preoperation and one day or three months after operation（ P 〈0.05）, and had no statistical significance between one day and three months after operation（ P 〉0.05）. [Conclusion]The PKP through one side approach is a minimally invasion, safe and effective technique for treating thoracic and lumbar osteoporotic vertebral compression fracture.