经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床研究

Clinical research of percutaneous kyphoplasty in the treatment of osteoporotic vertebral fractures

目的总结经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性椎体压缩骨折的临床效果。方法收集2007年7月～2011年9月广东省江门市中心医院骨科采用PKP治疗的患者136例(256椎),采用PKP治疗;采用疼痛视觉模拟评分(visual analogue scale,VAS)进行手术前后疼痛评估;观察椎体高度恢复及并发症情况。结果术后随访3～28个月,平均12个月;所有病例疼痛症状均缓解,VAS评分分别为术前(9.12±4.00)分、术后(2.89±1.40)分,差异有统计学意义(P<0.05);椎体高度均有明显的恢复,椎体前缘高度术前为(14.28±2.43)mm,术后为(20.51±2.26)mm;椎体后缘高度术前为(22.18±2.12)mm,术后为(23.49±2.35)mm,差异均有统计学意义(P<0.05);本组病例手术均获得成功,其中10例患者出现骨水泥渗漏,8例渗漏到椎体旁,2例出现椎体后缘渗漏,均未出现神经症状;3例术后第2天出现脑梗死。结论 PKP治疗骨质疏松性椎体压缩骨折可迅速有效地缓解患者的疼痛和恢复病椎的高度,术中术后并发症发生率低。

Objective To investigate the clinical efficacy of percutaneous kyphoplasty （PKP） on osteoporotic vertehral compressive fractures. Methods 136 patients （256 vertebra]s） with osteoporotic vertebral compression fractures from July 2007 to September 2011 in Department of Orthopedics of the Central Hospital of Jiangmen City were selected and treated with PKP, Visual analogue scale （VAS） method was used to assess the pre-and post-operative pain symptoms. Furthermore, vertebral height and the clinical complication were observed. Results All the cases were followed-up for 3-28 months, the average were 12 months; all the pain symptoms were found eased, the VAS score after operation （2.89±1.40） scores was lower than that before operation （9.12±4.00） scores, the difference was statistically significant （P 〈 0.05）; vertebral body height were found recovered, anterior vertebral height before operation were （14.28±2.43） mm, anterior vertebral height after operation were （20.51±2.26） mm, posterior vertebral height before operation were （22.18± 2.12） mm, posterior vertebral height after operation were （23.49±2.35） mm, the differences were all tatistically significant （P 〈 0.05）; all the cases are performed successfully, 10 cases of bone cement leakage were found, 8 cases of leakage were found in the vertebral body side, 2 cases of leakage were found in the posterior vertebral, no neurologic symptom was found; 3 cases. Conclusion PKP is a safe and effective method for treating osteoporotic vertebral fractures. It can rapidly release the backache, restore the body height of fractured vertebrae ,improve the life quailty of patients with less clinical syndromes.