经皮椎体后凸成形术治疗骨质疏松性胸腰椎骨折

The percutaneous kyphoplasty treatment of osteoporosis thoracolumbar vertebral compression fractures

目的探讨经皮椎体后凸成形术(PKP)治疗骨质疏松性胸腰椎体压缩性骨折的临床疗效。方法对59例患者的80个骨折椎体施行PKP,比较手术前后VAS评分、椎体高度、后凸Cobb角的变化,评估疗效。结果患者手术均成功,未发生脊髓、神经损伤。59例均获24个月的随访。术前、术后即刻、术后12个月、术后24个月的VAS值分别为6.06分±1.02分、2.45分±1.04分、2.80分±1.13分和2.90分±1.90分;后凸Cobb角度分别为24.62°±4.71°、21.71°±3.92°、22.20°±3.60°和22.90°±3.28°;椎体高度值分别为19.0mm±1.80 mm、26.3 mm±2.10 mm、25.9 mm±2.00 mm和24.2 mm±2.03 mm;术后各时段与术前比较3项差异均有统计学意义(P<0.05)。术后即刻、12个月、24个月的治疗有效率分别为93.00%、81.72%、72.09%。结论 PKP治疗骨质疏松性胸腰椎体压缩性骨折微创、安全,能迅速缓解疼痛,临床效果满意。

Objective To evaluate the clinical efficacy of percutaneous kyphoplasty （PKP） in treating refractoy low back pain in patients with osteoporotic thoracolumbar vertebral compression fractures. Methods PKP was used to treat 59 cases of osteoporotic vertebral compression fracture patients（80 vetebrae）. VAS scores,vertebral height and Cobb angle changes recorded before and after surgery were compared in order to analyse the effect. Results PKP was successfully performed on these patients, and there was no neurological impairment or bone cement allergy in these pa- tients. The 59 cases were successfully followed up for 24 months. VAS values were respectively 6.06 ± 1.02 points before operation,2.45 ± 1.04 points after the operation,2.80 ± 1.13 points in 12 months after surgery and 2. 90 ±1.90 points in 24 months after surgery, the kyphosis Cobb angles were respectively 24.62°± 4.71° ,21.71° ±3.92°, 22.20°±3.60° ,22. 90° ± 3.28°~, vertebral height value were respectively 19.0 mm ±1.80 mm,26. 3 mm ± 2. 10 mm,25.9 mm ±2. 00 mm, 24. 2 mm ± 2. 03 mm. All the differences were statistically significant （ P 〈 0. 05 ）. The treatment efficiency rates were respectively 93.00% after surgery, 81.72% in 12 months and 72.09% in 24 months. Conclusions PKP is effective for osteoporotic thoracolumbar vertebral compression fractures, which has minimal trauma and good security. It can rapidly relieve pain, obtain a satisfactory clinical result.