经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折的早期效果

The early effect of the percutaneous kyphoplasty(PKP) in the treatment of age-related osteoporotic vertebral compression fractures

目的探讨经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折的临床疗效。方法回顾性分析54例采用经皮椎体后凸成形术治疗老年骨质疏松椎体压缩性骨折患者的早期临床效果和并发症情况,比较术前、术后伤椎高度平均恢复率、Cobb角、视觉模拟评分法(VAS)评分及生活质量评分法(ADL)评分。结果 54例患者均顺利完成手术,47例获得6～24个月随访,平均随访时间为13.5个月。31患者术后疼痛即刻明显缓解,12例患者术后1周内腰背部棘旁两侧的肌肉仍有酸胀痛,予非甾体抗炎药处理症状逐步缓解,8周后症状均明显缓解或消失。4例患者在末次随访时仍有腰背痛,需口服镇痛药。术前与术后伤椎高度平均恢复率、Cobb角、VAS评分及ADL评分比较差异有统计学意义(P<0.05)。结论经皮椎体成形术治疗老年骨质疏松椎体压缩性骨折具有微创、明显缓解或解除腰背痛、早期离床等特点。严格掌握适应证和手术技巧可获得有效而安全的临床结果。

Objective To investigate the early clinical effects of percutaneous kyphoplasty in the treatment of age-related osteoporotic vertebral compression fractures.Methods Retrospected 54 cases with osteoporotic verebral compression fractures were treated with PKP,summarized early clinical effects and complications.analysis of preoperative and postoperative wound vertebral height average recovery rate,Cobb Angle,VAS scores and ADL scores.Results Operations in all the 54 cases were completed smoothly,47 cases for 6 to 24 months follow-up（mean 13.5 months）.postoperative pain in 31patients obtained remission immediately,1 week after operation,12 cases with lower back pain and need the non-steroidal anti-inflammatory medications,the symptoms remissed significantly or disappeared after 8 weeks postoperatively.At the last follow-up,4 patients still had low back pain and need oral analgesics.Preoperative and postoperative wound vertebral height average recovery rate,Cobb Angle,VAS scores and ADL scores was statistically significant.Conclusion PKP is a minimally invasive,effective and safe procedure that provides pain relief and stabilization of spinal stability and activities under the bed early,and improves quality of life at the same time.Grasping the indications Strictly and holding the surgical skills can be obtained clinical results efficiently and safely.