经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折

Effectiveness of percutaneous kyphoplasty in treatment of osteoporotic vertebral compression fracture

目的探讨经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折的临床疗效。方法 2004年12月-2008年12月在C臂X光机引导下共使用经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折患者33例54椎,男11例,女22例,年龄60-79岁,平均69岁。对患者术前、术后3天及末次随访时进行VAS、ODI评分,测量椎体平均高度及椎体后凸角。术后随访8-30个月,平均16个月。结果所有病例疼痛明显缓解,疼痛缓解率100%。2例发生骨水泥渗漏,但无临床症状。术前、术后3天及末次随访VAS评分分别为（8.0±0.76）分,（3.6±0.42）分和（3.9±0.58）分;ODI评分分别为（45±1.16）%,（21±0.25）%和（23±0.14）%;椎体平均高度由术前（14.5±2.3）mm提高到术后（23.4±2.6）mm,末次随访（23.1±1.3）mm;椎体后凸角由术前（22.40±12.15）°降低到术后（10.16±5.37）°及末次随访（11.25±6.57）°。所有指标数据术后3天、末次随访时与术前比较,差异均有统计学意义（P〈0.05）。术后3天与末次随访时相比差异无统计学意义（P〉0.05）。结论经皮椎体后凸成形术作为一种微创技术,能有效缓解疼痛,改善活动功能,提升生活质量,是治疗骨质疏松椎体压缩性骨折的安全有效的方法。

Objective To investigate the therapeutic effect of percutaneous kyphoplasty in the treatment of osteoporotic vertebral compression fracture.Methods During December 2004 to December 2008,33 patients（54 vertebra） received percutaneous kyphoplasty for osteoporotic vertebral compression fractures under ＂C＂ armed imaging guiding.There were 11 males and 22 females with the average age of 69 years（rang from 60-79 years）.A Visual Analog Scale（VAS）,the Oswestry Disability Index（ODI）,the mean vertebral body height and angle degree of rachiokyphosis were measured pre-operatively,post-operatively（three days after operation） and during the follow-up period.The mean follow-up period was 16 months（rang from 8 to 30 months）.Results All patients experienced dramatic pain relief after the operation,and response rate of pain relief was 100%.Asymptomatic cement leakage occurred in two vertebrae.The VAS was（8.0±0.76） preoperatively,（3.6±0.42） postoperatively and（3.9±0.58） during the follow-up period;and the ODI was（45±1.16）% preoperatively,（21±0.25）% postoperatively and（23±0.14）% during the follow-up period.The mean vertebral body height was restored from pre-operative（14.5±2.3） mm to post-operative（23.4±2.6） mm,and to（23.1±1.3） mm during the follow-up period.The angle degree of rachiokyphosis was lowered from（22.40±12.15）° preoperatively to（10.16±5.37）° postoperatively,and to（11.25±6.57）° during the follow-up period.There was a significant increment before and after operation（P〈0.05）,and there was statistically significant difference between preoperation and during the follow-up period（P〈0.05）.There was no statistically significant increment between postoperation and during the follow-up period（P〈0.05）.Conclusion The percutaneous kyphoplasty,as a minimally invasive technology,can relief pain,improve activity and enhance the quality of life effectively.This study suggests that kyphoplasty is a safe and effective procedure for osteoporotic vertebral compression fractures.