椎体成形术与椎体后凸成形术治疗胸腰椎压缩骨折

Clinical Study of Percutaneous Vertebroplasty and Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fracture of Thoracolumbar Spine

目的评估经皮椎体成形术(percutaneous vertebroplasty,PVP)和经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的临床效果。方法回顾性分析2003年6月至2008年6月间采用了PVP和PKP治疗的53例骨质疏松性胸腰椎压缩性骨折,于术前、术后3 d和术后3个月随访时进行疼痛强度评价的视觉模拟评分(visual analogue scale,VAS)及术前、术后3 d和术后3个月椎体前缘高度压缩变化测量。结果 53例患者手术操作全部成功,1例出现骨水泥渗透到椎体旁。疼痛完全缓解32例(60.4%),显著缓解21例(39.6%)。术后及随访6个月,VAS评分、椎体压缩率与术前比较有显著性差异(P<0.05)。长期随访观察疼痛无复发,X线片未见椎体高度丢失。结论 PVP及PKP治疗胸腰椎骨质疏松性椎体压缩骨折具有微创、安全、疗效优良、并发症少的优点,是治疗老年椎体压缩骨折的理想方法。合适的手术适应证选择和良好的术中操作是防止并发症的关键。

Objective To explore the clinical outcome of the percutaneous vertebroplasty（PVP）and percutaneous kyphoplasty（PKP）in the treatment of osteoporotic vertebral compression fracture（OVCF）in thoracolumbar spine.Methods The date of Fifty-three patients of thoracolumbar OVCF undergone PVP or PKP from Jun.2003 to Jun.2008 were gathered for this retrospective study.the visual analog scales（VAS）was used to assess pain severity before and after 3 days and 6 months,and the recover of anterior height of vertebrae body was used for radiographic assessments before and after at the 3 days and 6 months.Results All patients came through a desirable puncture and showed no clinical sympotom except for 1 case complicated with bone cement leakage into vertebral lateral.32 patients obtained total relief（60.4%）,21 patients obtained significant relief（39.6%）.Statistic analysis showed that preoperative VAS,the recover of anterior height of vertebrae body and ease of pain ODS had remarkable difference with those postoperatively and during the 6 month long follow up.Follow up found no recurrence of the symptoms,X-ray and CT films showed no loss of the vertebral height.Conclusion PVP and PKP can quickly relieve pain and enhance vertebral stability in treating thoraco-lumbar OVCF.