经皮椎体后凸成形术治疗骨质疏松性胸腰椎压缩骨折探讨

Percutaneous Kyphoplasty for Osteoporotic Vertebral Compression Fractures

目的探讨椎体后凸成形术(PKP)在治疗老年骨质疏松性椎体压缩骨折(VCF)中的应用。方法对2009年7月-2011年8月间收治的19例VCF患者采用PKP手术治疗并随访观察。采用视觉疼痛模拟评分法(VAS)评定患者术前、术后疼痛情况及术前、术后患椎前缘高度及Cobb角。结果患者均获随访6～24个月。术后腰背部疼痛均缓解。术前、术后3 d及术后3个月的VAS评分分别为(8.43±2.07)分、(2.75±1.13)分和(2.82±1.21)分;患椎前缘高度分别为(14.21±2.46)mm、(20.22±2.55)mm和(21.04±2.79)mm;Cobb角分别为(23.13±3.54)°、(7.56±2.62)°和(7.14±2.48)°。VAS评分、患椎前缘高度及Cobb角等指标,术后3 d、术后3个月与术前比较,经F检验,差异均有统计学意义(P<0.01)。结论 PKP能迅速缓解疼痛,可恢复部分椎体高度及后凸角度,是治疗老年VCF的一种有效方法。

Objective To evaluate the clinical outcomes of applying percutaneous kyphoplasty（PKP） in treatment of elderly patients with vertebral compression fracture（VCF） caused by osteoporosis.Methods Between Jul.2009 and Aug.2011,19 VCF patients underwent surgical treatment by PKP and were followed up.Visual analogue scales were used to evaluate the pain of the patients before and after the surgery and the sagittal plane deformity（scoliosis） by measuring Cobb＇s angle.Results Follow-up ranging from 6 to 24 months showed that all patients were postoperatively relieved from back pain,and VAS scores were 8.43±2.07 before operation,2.75±1.13 for three days after the procedure and 2.82±1.21 for postoperative three months,with corresponding height of anterior deformity（14.21±2.46） mm,（20.22±2.55） mm and（21.04±2.79） mm and Cobb＇s angle（23.13±3.54）°,（7.56±2.62） ° and（7.14±2.48）°,respectively.VAS scores,the height of anterior plane deformity and measurement of Cobb＇s angle were significantly different in statistics by Fisher test regarding postoperative three days and 3 months as compared with preoperative findings（P0.01）.Conclusion PKP can quickly alleviate the pain and partially improve the vertebral height,suggesting that this procedure can effectively treat the elderly patients with VCF resulted from osteoporosis.