经皮球囊扩张后凸成形术治疗骨质疏松性椎体压缩性骨折

Percutaneous kyphoplasty for the treatment of osteoporotic compression fracture of spine

目的评价经皮球囊扩张后凸成形术(PKP)治疗骨质疏松性椎体压缩性骨折的临床效果。方法采用PKP治疗骨质疏松性椎体压缩性骨折患者23例(26椎),记录术前和术后视觉模拟评分(VAS),测量术前和术后X线片椎体高度的变化。结果 23例均获得随访,时间3～24(9±2)个月。患者术后胸腰背部疼痛均明显缓解,VAS评分术前为(7.8±1.4)分,术后24h为(2.7±1.2)分(P<0.05),末次随访时为(2.8±1.3)分。手术椎体前、中柱平均高度由术前的(16±0.6)mm、(21±0.5)mm恢复到术后的(22±0.6)mm、(32±0.7)mm(P<0.05)及末次随访(23±0.7)mm、(30±0.9)mm。3例发生骨水泥渗漏,但均无神经、血管损伤或压迫症状。结论 PKP治疗骨质疏松性椎体压缩性骨折可迅速缓解疼痛、有效恢复骨折椎体高度,明显减少骨水泥渗漏率,是一种安全、有效、微创的治疗方法。

Objective To study the clinical effect of percutaneous kyphoplasty（PKP）for the treatment of osteoporotic compression fracture of spine.Methods 23 cases（26 vertebrae）of osteoporotic compression fracture of spine were treated with PKP.The effect was followed and evaluated.Results All 23 patients were followed up for average 9 months（range 3-24 months）.All cases got pain relief postoperatively.The mean VAS Pain score decreased significant from（7.8±1.4）preoperative to（2.7±1.2）（P0.05）postoperatively,and was（2.8±1.3）at final follow-up.The mean height of anterior and medial vertebral body were（16±0.6）mm,（21±0.5）mm preoperatively and（22±0.6）mm,（32±0.7）mm（P0.05）postoperatively,and（23±0.7）mm,（30±0.9）mm at final follow-up.There were 3 cases occurred bone cement leakage.No nerve and vessel injury or compression sign was found.Conclusions PKP can quickly release the back pain,effectively restore the height of the compressed vertebrae and significantly decrease the cement leakage.It is a safe,effective and minimally invasive treatment for osteoporotic compression fracture of spine.