摘要
目的:评价球囊扩张经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折的临床效果。方法:2008年10月至2010年5月应用经皮球囊扩张椎体后凸成形术治疗41例骨质疏松性椎体压缩性骨折患者,男10例,女31例;年龄61~83岁,平均67.5岁。患者主要症状是腰背部疼痛,影响正常生活,共65个椎体,骨折部位T9-L4。按照VAS评分、影像学资料、Oswestry评分标准分别对患者疼痛、椎体高度和Cobb角、日常活动功能进行观察。结果:所有手术均顺利完成,无严重手术并发症。有7个椎体发生骨水泥渗漏,均未出现临床症状。术后患者腰痛均明显缓解,随访7~26个月,平均14个月,视觉模拟评分(VAS)由术前的(8.38±0.60)分下降至术后的(2.45±0.38)分,最终随访为(2.53±0.36)分;Oswestry功能评分术前为(40.00±1.16)分,术后为(17.00±2.11)分,末次随访为(15.00±1.41)分;椎体前缘的高度术前平均为(14.64±1.30)mm,术后为(25.11±1.12)mm,末次随访为(23.16±1.14)mm;伤椎后凸角度术前平均为(30.17±1.45)°,术后为(12.10±1.37)°,末次随访为(14.31±0.51)°。各指标术后与术前、最终随访时与术前差异均有统计学意义(P<0.05);术后与最终随访时差异无统计学意义(P>0.05)。结论:球囊扩张经皮椎体后凸成形术是治疗老年骨质疏松性椎体压缩性骨折的有效方法,能迅速缓解疼痛,有效恢复骨折椎体的高度及后凸畸形。具有创伤小,安全性好的优点。
Objective:To evaluate the clinical outcome of percutaneous kyphoplasty in treating vertebral compression fractures.Methods:From October 2008 to May 2010,41 patients with osteoporotic vertebral compression fractures were treated with percutaneous kyphoplasty.There were 10 males and 31 females,ranging in age from 61 to 83 years,with an average of 67.5 years.Fracture site was from T9 to L4 including 65 vertebral bodies.Clinical symptom was lumbar and back pain to affect orthobiosis.The pain,height of vertebral body,Cobb angle,function of daily activities were analyzed by VAS sore,imaging data,Oswestry score before and after operation.Results:All operations were successful and no severe complications were found.Bone cement leakage occurred in 7 vertebrae,but no clinical sympton.All lumbago obtained obviously anesis after operation.All patients were followed up from 7 to 26 months with an average of 14 months.Preoperative,postoperative and at final follow-up,VAS score was 8.38±0.60,2.45±0.38,2.53±0.36,respectively;Oswestry score was 40.00±1.16,17.00±2.11,15.00±1.41,respectively;height of vertebral body was(14.64±1.30),(25.11±1.12),(23.16±1.14) mm,respectively;Cobb angle was(30.17±1.45)°,(12.10±1.37)°,(14.31±0.51)°,respectively.There was significant difference between postoperative and preoperative,and between at final follow-up and preoperative(P〈0.05).There was no significant difference between final follow-up and postoperative(P〉0.05).Conclusion:Percutaneous kyphoplasty is effective for treatment of senile osteoporotic vertebral compression fractures,which can expeditiously relieve pain and effectively recover height of vertebral body and kyphosis Cobb angle,has advantages of minimal trauma and good security.
出处
《中国骨伤》
CAS
2011年第7期570-573,共4页
China Journal of Orthopaedics and Traumatology
关键词
脊柱骨折
骨质疏松
后凸成形术
Spinal fractures
Osteoporosis
Percutaneous kyphoplasty