观察微创球囊扩张经皮椎体后凸成形术在治疗老年人骨质疏松性胸腰椎骨折的疗效观察

Percutaneous kyphoplasty for osteoporotic thoracolumbar fracture in the elderly

目的探讨应用经皮椎体后凸成形术（PKP）在治疗老年人骨质疏松性胸腰椎骨折的临床疗效。方法选择2008年3月-2010年4月收治的26例骨质疏松性胸腰椎骨折患者采用PKP治疗，其中男11例，女15例；年龄55—70岁，平均67岁。其中T1210例，L18例，L25例，133例，应用视觉模拟疼痛评分（VAS）及伤椎形态变化，同时通过手术节段x线测量计算伤椎的高度恢复率及受伤节段后凸矫正率。结果手术全部成功，平均手术时间为40分钟，注入骨水泥平均3．8ml，本组患者平均随访时间为12个月。术后伤椎处疼痛均显著缓解，患者的VAS评分由术前的平均（7．1±1．5）分降至术后平均（1．2±0．4）分，椎体高度由术前平均（53．4±8．9）％升至术后的（83．6±10．2）％，椎体后凸畸Cobb角平均矫正9．4°。无严重并发症，患者对治疗效果满意。结论应用PKP治疗老年人骨质疏松性胸腰椎骨折可矫正后凸畸形、迅速缓解疼痛、有效恢复骨折椎体的高度，避免骨水泥渗漏，效果明显。

Objective To discuss the clinical efficacy of percutaneous kyphoplasty （PKP） in the treatment of osteoporotic thoracolumbar fracture in the elderly. Methods 26 cases of osteoporotic osteoporotic thoracolurahar fracture who were about to receive PKP were selected from April 2008 to March 2010. There were 11 male cases and 15 female cases, aged 55 to 70 years, with an average of 67 years. T12 fracture was found in 10 cases, L1 fracture in 8 cases, 1.2 fracture in 5 cases and L3 fracture in 3 cases. Visual analog pain score （ VAS ） and vertebral morphological change were used to calculate the vertebral height restoration rate and kyphosis correction rate, together with X ray measurement of the surgical segment. Resuits All the surgeries were successfully performed, the mean operation time was 40 minutes, the average amount of bone cement injected was 3.8ml. Patients in this group were followed up for 12 months in average. Pain in the injured vertebra was relieved significantly after operation, the average VAS score decreased from （7.1 ± 1.5 ） points to （ 1. ：2 ± 0.4） points, the average vertebral height increased from （53.4 ± 8.9） % to （83.6 ± 10.2） %, the average correction of Cobb angle was 9.4°. No serious complications occurred, and patients were satisfied with clinical efficacy. Conclusions PKP is effective for osteoporotic thoracolumbar fracture in the elderly, for it cancorrect kyphosis, relieve pain quickly, and effactively restore vertebral body height and avoid leakage of bone cement.