经皮椎体后凸成形注入骨水泥治疗骨质疏松性胸腰椎压缩骨折

Percutaneous kyphoplasty with bone cement treats osteoporotic thoracolumbar vertebral compressive fractures

背景:经皮椎体后凸成形通过球囊的扩张恢复压缩椎体高度,并注入骨水泥强化椎体,恢复其解剖形态和力学性能。目的:评估聚甲基丙烯酸甲酯骨水泥经皮椎体后凸成形治疗胸腰椎骨质疏松性椎体压缩骨折的疗效及安全性。方法:对41例骨质疏松性胸腰椎椎体压缩骨折患者在C型臂X射线机引导下行聚甲基丙烯酸甲酯骨水泥经皮椎体后凸成形治疗,对比治疗前后患者疼痛评分及影像学检测结果。结果与结论:所有手术顺利完成,无严重并发症发生。随访3个月后,椎体前、中缘平均高度及Cobb角均较治疗前改善(P<0.05),且疼痛目测类比评分较治疗前明显降低(P<0.01)。表明聚甲基丙烯酸甲酯骨水泥经皮椎体后凸成形治疗骨质疏松性压缩骨折安全性高,可缓解患者疼痛,有效改善患者生活质量。

BACKGROUND： Percutaneous kyphoplasty can recover the vertebral height after compressive fractures through extension of the sacculus. Bone cement is injected in order to strengthen the vertebral bodies, and recover anatomic form and mechanical property. OBJECTIVE： To evaluate the efficacy and safety of percutaneous kyphoplasty in treating osteoporotic thoracolumbar vertebral compressive fractures. METHODS： Totally 41 cases of osteoporotic thoracolumbar vertebral compressive fractures were treated by percutaneous kyphoplasty with injection of polymethylmethacrylate under ＂C＂ armed fluoroscopy image guiding. The clinical effect was evaluated by observing the changes of visual analog scale （VAS） and imaging. RESULTS AND CONCLUSION： All cases were treated successfully without any complication. During the 3-month follow-up after operation, the mean height of the anterior and media vertebral body and the Cobb＇s angle were improved obviously after operation （P 〈 0.05）, and VAS was decreased at the same time （P 〈 0.01 ）. It can conclude that the percutaneous kyphoplasty is simple and safe in treating osteoporotic thoracolumbar vertebral compressive fractures, which can fast relieve pain, and improve patient＇s quality of life.