经皮穿刺球囊扩张椎体成形术治疗骨质疏松性压缩性骨折的临床疗效分析

Percutaneous balloon expansion vertebral angioplasty treatment osteoporotic fractures of the clinical efficacy analysis of compressibility

目的:分析探讨经皮穿刺球囊扩张椎体成形术(PKP)在骨质疏松性压缩性骨折(OVCF)治疗中的临床疗效。方法:收集2007年8月～2010年8月在本院诊治的骨质疏松性压缩性骨折患者48例,患者均经进行双光子骨密度测定、磁共振显影、术前X线、CT/MRI等临床影像学检测进行病症诊断。在C型臂X线机透视下,采用经皮穿刺双侧(或单侧)椎弓根入路,在X线透视注射骨水泥。术后观察X线下患者椎体高度变化,采用视觉模式数字评分法对患者疼痛程度进行衡量评价。结果:术后随访48例患者病椎椎体高度均无再塌陷或高度丢失。术后3 d内,患者胸、腰背疼痛症状明显缓解,无症状加重者,且未出现脊神经损伤症状,患者中4例出现骨水泥于椎体前方少量外溢但未出现严重并发症。手术前后VAS分别为(8.75±0.77)分及(2.31±1.32)分,P<0.01;伤椎体高度分别为(14.4±3.1)mm及(24.8±2.7)mm,P<0.01。结论:经皮穿刺球囊扩张椎体成形术作为一种新型微创技术,在骨质疏松性压缩性骨折治疗中疗效显著,能有效改善患者术后的生存质量。

Objective： To analyse the discussion percutaneous balloon angioplasty （expansion vertebral PKP） in osteoporotic fractures （compressibility OVCF） therapy in clinical curative effect. Methods： We collected in August 2007 to August 2010 treated in our hospital since osteoporotic compressibility fracture patients 48 cases and patients were subject to for two-photon bone density testing, and nuclear magnetic resonance imaging, preoperative X-ray, CT/MRI etc clinical imaging detection disease diagnosis. In C arm X-ray machine fluoroscopy, using percutaneous bilateral （unilateral or bilateral） pedicle into the road, in X-ray fluoroscopy injection bone cement. Postoperative observation X line patients vertebral height variations, using visual patterns digital pointrating method to evaluate the degree of patients with pain. Results： The follow-up of 48 patients with vertebral disease were no vertebral body height again collapse or highly lost. After 3 days, patients bosom, waist, back pain symptoms without symptom aggravating obviously alleviate the backbone nerve injury, and does not appear symptoms, 4 cases occur in patients with vertebral bone cement in front a few spillover but does not appear serious complications. Before and after operation, respectively plus or minus VAS （8.75±0.77） points and （2.31±1.32） points, P〈0.01, injury vertebral body height, respectively （14.4±3.1） mm and （24.8±2.7） mm, P〈0.01. Conclusion： Percutaneous balloon expansion vertebral angioplasty as a new micro-traumatic techniques in osteoporotic fractures compressibility treatment of curative effect is distinct, can effectively improve the life quality of patients who underwent.