PVP治疗骨质疏松性椎体压缩骨折27例临床观察

Clinical Observation of 27 Cases with Osteoporotic Vertebral Compression Fractures Treated by PVP

目的探讨经皮穿刺椎体成形术治疗骨质疏松性椎体压缩骨折的骨水泥渗漏情况和临床效果。方法回顾性收集我科2008年1月至2010年12月实施的经皮椎体成形术27例(男性6例,女性21例;年龄54～89岁,平均60.7岁)共42节椎体,均为骨质疏松性压缩骨折。通过对术后影像资料的分析统计骨水泥渗漏情况,并采用疼痛视觉模拟标度(visualanaloguescale,VAS)评价患者术前、术后第二天腰背疼痛情况。结果 27例共计42节椎体均成功实施经皮椎体成形术,每个椎体骨水泥注射量在1.5～5ml,平均(2.58±0.30)ml,共有7节椎体出现渗漏,1节发生椎间盘渗漏,其余6节为椎体旁渗漏,总体渗漏率为16.7%(7/42),未见神经根、脊髓压迫症状等其它相关并发症。所有患者术后VAS评分(1.9±0.3)较术前(7.5±0.6)明显改善(P<0.001)。结论 PVP能迅速缓解骨质疏松性椎体压缩骨折患者疼痛,手术安全性高,并发症少,适合基层医院开展。

Objective To investigate the leakage of bone cement and effectiveness of percutaneous vertebroplasty for osteoporosis vertebral compression fractures. Methods 42 vertebrae of 27 patients（6 male and 21 female;age range 54 ～ 89 years with the mean age of 66.7 years） with osteoporosis compression fractures were performed percutaneous vertebroplasty from January 2008 to December 2010. The leakage of bone cement was evaluated according to the post-operative image,and the pain before operation and in the second day after operation was measured by using the visual analogue scale（VAS） . Results The total of 42 vertebral bodies in 27 cases were successfully implemented percutaneous vertebroplasty,the injection volume of bone cement per vertebra was 1.5 ～ 5 ml,with an average of（2.58 ± 0.30） ml,there were seven vertebrae leakage,one was in the intervertebral discs,and the remaining six were adjacent vertebral body leakage,and the overall leakage rate was 16.7%（7/42） ,no nerve root and spinal cord compression symptoms and other complications occurred. The mean VAS pain score decreased significantly（P 0.001） from（7.5 ± 0.6） before PVP to（1.9 ± 0.3） after PVP. Conclusion PVP is effective in facilitating pain relief in patients with osteoporotic vertebral compression fractures,and is easy to be performed in basic hospital in China.