经皮椎体后凸成形术治疗老年椎体压缩性骨折的疗效观察

Effect Observation on Percutaneous Kyphoplasty in the Treatment of Elderly Vertebral Compression Fractures

目的探讨经皮椎体后凸成形术治疗老年椎体压缩性骨折的临床效果。方法 2009年1月至2010年12月,58例(62个椎体)压缩性骨折患者在C臂引导下,经皮向椎体内注入聚甲基丙烯酸甲酯(PMMA)骨水泥,术后进行疼痛的VAS评分,拍摄X线片观察Cobb角的矫正情况。结果 58例均顺利完成手术。VAS评分显示患者术后胸腰背痛均明显缓解(P<0.05);术后X线片复查显示伤椎高度基本恢复,后凸Cobb角术后矫正良好(P<0.05)。4例椎体出现骨水泥渗漏,但均未引起临床症状。12个月的随访显示,治疗部位疼痛无明显加重,椎体外形无明显改变。结论经皮椎体后凸成形术治疗老年胸腰椎体压缩性骨折可有效恢复压缩椎体的高度,迅速缓解疼痛,是一种安全有效的微创技术。

Objective To investigate the clinical effect of percutaneous kyphoplasty in the treatment of senile vertebral compression fractures.Methods 58 cases（62 vertebrae） in patients with compression fractures were inserted with polymethyl methacrylate（PMMA） by guide of C-arm from January 2009 to December 2010.Visual analogue scale（VAS） was used to evaluate pain and Cobb angle was measured to observe the correction by X-ray films.Results 58 cases were all successfully operated.VAS showed significant relief of postoperative thoracic and lumbar back pain（P〈0.05）;postoperative X-ray re-checks showed recovery of the fractured vertebral height,and Cobb angles got better correction（P〈0.05）.Four cases had vertebral cement leakage,but did not cause clinical symptoms.12 months of follow-up showed neither pain increase of treatment location,nor significant change of vertebral shape.Conclusion Percutaneous kyphoplasty for treatment of elderly thoracolumbar vertebral compression fractures can effectively restore the compressed vertebral height and rapidly relieve pain,which is a safe and effective minimally invasive technique.