经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折

Treatment of osteoporotic vertebral vertebral compressive fractures in elderly patients with percutaneous kyphoplasty

目的 探讨经皮椎体后凸成形术（PKP）治疗老年骨质疏松性椎体压缩性骨折的临床疗效.方法 30例老年骨质疏松性椎体压缩骨折患者在C臂机引导下行PKP治疗,通过疼痛视觉模拟评分法（VAS）,测量Cobb角及术前、术后和末次随访椎体高度等评价疗效.结果 所有手术均顺利完成,疼痛明显缓解,椎体高度无明显丢失,未出现严重骨水泥渗漏,无严重并发症发生;VAS由术前的7.7±1.0下降至术后的2.3±0.7,末次随访的2.4±0.6;Cobb角由术前的（29±5.4）°矫正到术后的（21±3.5）°,末次随访时的（22±3.6）°;椎体高度由术前的（12.9±2.6）mm到术后的（21.5±1.8）mm,末次随访时的（21.3±1.7）mm.术后与术前、末次随访与术前差异均有统计学意义（P〈0.05）,术后与末次随访差异无统计学意义（P＞0.05）.结论 经皮椎体后凸成形术创伤小,安全性高,能有效缓解疼痛,矫正后凸畸形,是一种治疗老年骨质疏松性椎体压缩骨折安全有效的方法.

Objective To evaluate the clinical effect of percutaneous kyphoplasty（PKP）on osteo- porotic vertebral compressive fractures （OVCFs） in elderly patients. Methods Thirty elderly patients with OVCFs were treated with PKP under the guidance of C-arm X-ray. The clinical effects were evaluated with visual analogue scale; The cobb angle, and the preoperative, postoperative and final follow-up height of vertebral bodies were measured. Results All cases were successfully treated without serious postopera- tive complications. Pain relief and recovery of vertebral body height were remarkable. No severe cement leakage occurred. Visual analogue scale pain score decreased from 7.7 ± 1.0 preoperatively to 2.3 ± 0.7 postoperatively, with the final follow-up score of 2.4 ± 0.6. The cobb angle improved from （ 29 ± 5.4 ）°preoperatively to（21 ± 3.5 ）° postoperatively, with the final follow-up score of（ 22 ± 3.6）°. The height of vertebral bodies improved from（ 12.9 ± 2.6 ） mm preoperatively to （ 21.5 ± 1.8 ） mm postoperatively, with the final follow-up of（ 21.3 ± 1.7） mm. There was significant difference between postoperative and preoper- ative conditions, and between final follow-up and preoperative condition. There was no significant difference between final follow-up and postoperative condition. Conclusion PKP has advantages of miniMal trauma and good security, and can relieve pain and correct kyphosis effectively. It is a safe and effective means of treating OVCFs in elderly patients.