经皮椎体后凸成形术治疗胸腰椎骨质疏松性压缩骨折375例

Percutaneous kyphoplasty in treating thoracolumbar osteoporotic compressed fractures(report of 375 cases)

目的探讨经皮椎体后凸成形术(PKP)治疗胸腰椎骨质疏松性压缩骨折的疗效。方法自2007年1月～2010年3月,采用球囊骨水泥系统行PKP治疗胸腰椎骨质疏松性压缩骨折375例(403椎)。结果本组均获随访6个月。患者的平均VAS评分术前为(7.32±1.83)分、术后第3天为(2.51±1.24)分、随访6个月时为(2.15±1.62)分,后两者与术前比较差异均有统计学意义(P<0.01)。术后X线复查,发现骨水泥少许渗漏的有34例(42椎),但无神经压迫症状。椎体前缘的平均高度术前为(15.32±2.05)mm、术后为(23.80±2.86)mm,差异有统计学意义(P<0.05);椎体中部的平均高度术前为(13.82±2.79)mm、术后为(22.32±2.54)mm,差异有统计学意义(P<0.05),提示伤椎高度恢复明显。Cobb角平均值由(26.20±8.91)°降至(12.70±8.92)°,差异有统计学意义(P<0.05)。结论胸腰椎骨质疏松性压缩骨折采用PKP治疗能缓解疼痛、恢复椎体高度,疗效显著。

Objective To study the efficacy of percutaneous kyphoplasty in treating thoracolumbar osteoporotic compressed fractures. Methods From January 2007 to March 2010,375 cases （403 vertebrae）of thomcolumbar osteoporotic compressed fractures underwent percutaneous kyphoplasty. Results VAS scores were 7.32±1.83 points preopemfively,2.51±1.24 points at day 3 and 2.15±1.62 points in 6 months after operation. There was significant difference before and after operation, and be- tween follow-up of 6 months after operation and before operation（P 〈0. 05）.The routine X-ray review was done in next day.Ex- tra-vertebral leakage of bone cement was observed in 34 cases （42 vertebrae） , while caused no nervous symptoms.Preoperative- ly,the anterior vertebral height was （15.32±2.05）mm and the mid vertebral height （13.82±2.79）mm, while postoperatively the anterior and mid ones were （23.80±2.86）mm and （22.32±2.54）mm （P 〈0.05）.The average Cobb＇s angle improved from （26.20± 8.91）° preoporatively to （12.70±8.92）°postoperatively （P 〈0.05）. Conclusion Pereutaneous kyphoplasty can efllcienfly relieve back pain of the wounded, restore the vertebral height in the treatment of thoracolumbar osteoporotic compressed fractures.