应用Fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折

Fabric pod kyphoplasty for osteoporotic vertebral fractures

目的：评估应用fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折的临床效果。方法：2007年12月～2010年4月应用fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折患者13例共15个椎体,男2例,女11例;年龄56～81岁,平均72.2岁;T9 1例,T11 2例,T12 5例,L1 5例,L2 2例;椎体后壁骨折2个椎体,其余椎体后壁完整。均无脊髓和神经受损的症状和体征,疼痛节段椎体MRI脂肪抑制序列均为高信号,VAS评分为8.9±1.4分,Oswestry功能障碍指数（ODI）为（86.1±9.7）%,伤椎椎体前缘高度为14.50±1.34mm,伤椎后凸Cobb角度为28.50°±1.85°。随访观察患者的VAS评分、ODI及影像学改变情况。结果：患者均安全耐受手术,手术时间每节段36～58min,平均45min。未出现骨水泥渗漏,无感染、血管栓塞、脊髓或神经损伤等并发症。术后患者疼痛均明显缓解,术后24h VAS为2.1±1.3分,ODI为（30.5±7.6）%,伤椎椎体前缘高度为23.20±1.12mm,伤椎后凸Cobb角度为11.30±1.40°,与术前比较均有差异性差异（p〈0．05）。随’方6～22个月，平均12个月．末次随访时VAS为2．2±1．5分，ODI为（32．7±8．4）％，伤椎椎体前缘高度为22．82±0．85mm，伤椎后凸Cobb角度为12.48°±0．70°，与术前比较均有显著性差异（P〈0．05），与术后24h比较均无显著性差异（P〉0．05）。结论：应用labric pod行椎体后凸成形术治疗骨质疏松性椎体骨折可显著缓解疼痛、有效恢复骨折椎体的高度，避免骨水泥渗漏，近期疗效满意。

Objective：To evaluate the clinical and radiographical outcomes of fabric pod kyhoplasty for osteoporotic vertebral fractures（OVFs）.Method：13 patients（11 females and 2 males） who sustained OVFs underwent fabric pod kyphoplasty between December 2007 and April 2010.The mean age was 72.2 years old（range,56-81 years）.A total of 15 painful OVFs（1 T9,2 T11,5 T12,5 L1,2 L2） were enrolled in our study.Except ford 2 patients,all patients had an intact posterior vertebral wall,and MRI showed marrow edema on fat-saturated T2-weighted sequences.Preoperative and postoperative of visual analogue scores（VAS）,Oswestry disability index（ODI）,and radiographic results were compared.Result：All patients got significant pain relief.The VAS score improved from 8.9±1.4 to 2.1±1.3 after operation,and was 2.2±1.5 at the finall follow-up.There was significant improvement between the preoperative and postoperative values（P〈0.05）,but no difference between postoperative and final follow-up values were noted（P〉0.05）.Compared with preoperative ODI scores,the postoperative ones showed significant improvement[（86.1±9.7）% vs.（30.5±7.6）%].The final follow-up ODI was（32.7±8.4）%.The height of anterior column of the vertebrae increased from pre-operative 14.50±1.34mm to post-operative 23.20±1.12mm and 22.82±0.85mm at final follow-up.There was significant improvement between the preoperative and postoperative ODI values（P〈0.05）,but no difference between the postoperative and final follow-up values were noted（P〉0.05）.The kyphotic angle improved from pre-operative 28.50°±1.85° to post-operative 11.30°±1.40° and 12.48°±0.70° at final follow-up.There was significant improvement between preoperative and postoperative values（P〈0.05）,but no difference between the postoperative and final follow-up values were noted（P〉0.05）.Conclusion：Fabric pod kyphoplasty is safe and reliable for painful OVFs,which can prevent bone cement leakage and ensure satisfying short-term results.