过伸复位联合单侧入路的椎体成形术治疗骨质疏松性椎体压缩骨折

Over-extending reduction combined with unilateral approach percutaneous vertebroplasty for the treatment of vertebral compression fractures due to osteoporosis

目的观察过伸复位联合单侧入路的经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折的效果。方法术前牵引垫枕,术中利用骨科手术床行过伸复位,再行PVP治疗。在术前、术后3 d、术后12个月随访时进行疼痛视觉评分(VAS),计算术前、术后压缩椎体高度恢复率。结果 16例20个椎体操作成功,骨水泥向椎体前方渗漏5例,侧方渗漏2例,向椎间盘内渗漏2例,无椎体后方渗漏。VAS评分由术前8.5±1.2降低至2.5±1.4,骨折椎体高度恢复率为(40.1±23.5)%。结论过伸复位联合单侧入路的PVP是治疗骨质疏松性椎体压缩骨折的有效方法。

Objective To assess the clinical effect of over-extending reduction combined with percutaneous vertebroplasty （PVP） in treating vertebral compression fractures caused by osteoporosis. Methods A total of 16 patients with vertebral compression fractures due to osteoporosis were treated with over-extending reduction by using traction on the operation table, and then PVP through trans-singlepedieular approach was performed on the fractured vertebra. The visual analogue scale （VAS） was used to evaluate the clinical effectiveness. The preoperative and postoperative heights of the fractured vertebral body were determined, and the vertebral height recovery ratio was calculated. Results Technical success was achieved in 20 vertebrae of 16 cases. Bone cement leakage was observed in front of the vertebral body （n = 5）, in the side of vertebral body （n = 20） and within the intervertebral disc （n = 2）. After the treatment VAS score decreased from preoperative 8.5 ±1.2 to postoperative 2.5± 1.4. The vertebral height recovery ratio was （40.1± 23.5）%. After the surgery, the VAS score and the vertebral height were significantly improved （P 〈 0.05）. Conclusion The over-extending reduction combined with PVP through trans-single-pedicular approach is an effective treatment for vertebral compression fractures caused by osteoporosis.（J Intervent Radiol, 2012, 21： 330-333）