球囊扩张椎体后凸成形术对骨质疏松压缩骨折止痛和椎体高度恢复的影响

The effects of pain relief and restored the vertebral heights by percutaneous balloon kyphoplasty for the treatment of painful osteoporotic vertebral compression fractures

目的评价应用经皮球囊扩张椎体后凸成形术治疗对疼痛性胸腰椎骨质疏松压缩骨折止痛效果和对椎体高度恢复的影响。方法应用球囊扩张椎体后凸成形术治疗胸腰椎骨质疏松压缩骨折患者45例85椎（T4-L4）,年龄53~86岁（平均71岁）,有症状的节段均做MRI证实。手术后当天和术后随访分别进行疼痛得分VAS（visual analog scale）测定;手术前后在侧位X线片测量骨折椎体前、中部的高度。结果球囊扩张椎体后凸成形术可以快速止痛、明显增加脊柱负重能力,术后24个月患者疼痛得分从8.3分降至2.2分,手术后85例骨折椎体前、中部的高度增加到了原椎体高度的（78.82±21.84）%和（72.35±22.65）%。椎体楔形变从15°降至10°,这种结果至少保持2年时间。无一例造成骨折后椎管狭窄加重,无严重并发症的发生。结论球囊扩张椎体后凸成形术可以快速改善运动功能和减轻疼痛。可安全增加椎体高度,迅速恢复老年患者行走能力,效果优良。

Objective To evaluate the effects of pain relief and restored the vertebral heights of percutaneous balloon kyphoplasty as a minimally invasive treatment in patients with painful osteoporotic vertebral compressive fractures（VCF）.Methods A retrospective analysis was conducted in 45 consecutive patients（32 females,13males）;whose ages ranged from 53 to 86 years（mean age 71 years）.Symptomatic levels were identified by correlating the clinical presentation with MRI.The interval between onset of symptoms and surgical intervention ranged from 2 days to 1 year.85 levels（42 thoracic,43 lumbar）were treated in this cohort.Immediate and postoperative 24-month follow-up visit.Visual analog scale（VAS）pain scores,preoperative and postoperative anterior,midline vertebral heights for fractured vertebrae were measured on lateral radiographs to evaluate the success of the procedure.Results The method demonstrated swift pain relief associated with an evident augmentation in the weight-bearing resistance.Pain was reduced from 8.3 to 2.2 points.By balloon kyphoplasty the anterior,midline vertebral heights of 85 fractured vertebral bodies could be increased up to（78.82±21.84）%,（72.35±22.65）% and the wedge decreased from 15 to 10 degrees.This effect persisted over a period of two years.In none of our patients,the procedure led to worsening of the fracture-induced narrowing of the spinal canal.No device-related important complications occurred.Conclusions Balloon kyphoplasty results in immediate clinical improvement of mobility and pain relief.It safely increases vertebral body height,and quickly returns geriatric patients to higher activity levels,leading to increased independence and quality life.The short-term results are excellent.