球囊在胸腰椎压缩骨折经皮椎体后凸成形术中的应用

Application of Balloon Percutaneous Kyphoplasty in the Treatment of Thoracic and Lumbar Vertebral Compression Fracture

[目的]探讨球囊在胸腰椎压缩骨折经皮椎体后凸成形术（PKP）中应用的临床疗效.[方法] 自2010年1月至2011年5月对58例共64个椎体骨折患者,应用球囊扩张系统进行经皮穿刺、塌陷椎体扩张后注入骨水泥.随访观察患者疼痛视觉模拟评分（VAS）及并发症情况.[结果] 64个椎体经单侧或双侧椎弓根穿刺成功完成手术,手术时间30~120 min,骨水泥注入量每个椎体3.0~7.0 mL,骨水泥返流入椎旁静脉3个椎体,无椎管内漏及椎间隙漏等并发症,均无临床症状.随访5~21个月.所有患者疼痛缓解,VAS术前平均为（7.5±0.7）分,术后d1为（3.6±0.4）分,d7为（2.7±0.5）分,术后1个月为（2.5±0.5）分.手术前后VAS差异显著（ P 〈0.05）.[结论]球囊扩张应用于胸腰椎压缩骨折（PKP）能达到消除疼痛、恢复椎体高度的目的,是治疗胸腰椎压缩骨折的有效方法.

[Objective]To explore the clinical efficacy of balloon system in percutaneous kyphoplasty for the treatment of thoracic and lumbar vertebral compression fracture. [Methods]Totally 58 patients with verte- bral fracture（64 vertebral bodies） underwent percutaneous kyphoplasty by using balloon system from January 2010 to May 2011. The bone cement was injected into the collapsed vertebrae. The visual analogue scale （VAS） and complications were observed during follow up. [Results] All 64 vertebral bodies successfully com- pleted the procedure via unilateral or bilateral pedicle puncture. The operation time was 30~ 120 minutes. The mean volume of cement injected into each vertebra body was 3.0~7.0ml. Back flow of bone cement into para- vertebral veins was observed in 3 vertebral bodies. No complications such as leakage in spinal canal and inter- vertebral space occurred. No clinical symptoms were found. The symptoms of the patients were improved dur- ing a follow up of 5~21 months. The score of VAS was 7.5±0.7 before operation, 3.6±0. 4 at first day af- ter operation, 2.7±0.5 at a week after operation and 2.5±0.5 at a month after operation. There was signifi- cant difference in VAS between before and after operation（ P 〈0.05）. [Conclusion]The application of balloon system in percutaneous kyphoplasty can relieve pain and restore the height of vertebral body, so it is an effec- tive method for the treatment of thoracic and lumbar vertebral compression fracture.