经皮椎体成形术治疗骨质疏松性胸腰椎压缩骨折疗效分析

Efficacy analysis of percutaneous vertebral angioplasty in treatment of compression osteoporotic fractures of thoracic and lumbar vertebrae

目的研究经皮椎体成形手术(PVP)应用于骨质疏松性胸腰椎压缩性骨折治疗的临床疗效。方法在C臂X线机的监控下,用骨水泥做填充材料,由双侧或者单侧椎弓根穿刺实施经皮椎体成形手术(即PVP)28例,共36个椎体,总结治疗方法及疗效。结果经3～12个月的随访,疼痛完全缓解者18例,部分缓解者8例,轻度缓解1例,无效1例,总有效率为92.86%。手术中有1例穿刺针透过锥体前壁,4例患者出现骨水泥渗漏现象,无不良后果。结论 PVP法在骨质疏松性胸腰椎骨折的治疗上有着高效、安全的优点,手术中要掌握准确穿刺、确认"疼痛椎"与注射填充材料的关键技术。

Objective To study the efficacy of percutaneous vertebral angioplasty （PVP） in treatment of compression osteoporotic fractures of thoracic and lumbar vertebrae.Methods Twenty-eight cases of patients （total of 36 vertebral body） were given PVP treatment by bilateral or unilateral pedicle percutaneous puncture in monitoring of C arm X-ray machine,with bone cement as fill material,to summarize treatment method and curative effect.Results After 3-12 months follow-up,the pain complete remission in 18 cases,the partial remission in 8 cases,mild remission in 1 case,ineffective in 1 case.The total effective rate was 92.86%.In the operation,the needle through cone antetheca in 1 case,Bone cement leakage phenomenon appeared in four patients,and there was no bad consequences.Conclusion PVP has the advantages of high efficiency,safety in treatment of osteoporotic fractures of thoracic and lumbar vertebrae,in the surgery we should master the accurate puncture,confirmed ＂pain vertebral＂ and key technology of materials filled injection.