经皮椎体成形术在老年人多次骨质疏松性椎体压缩性骨折中的应用

Application of percutaneous vertebroplasty in the elderly multiple osteoporotic vertebral compression fractures

目的探讨经皮椎体成形术（percutaneous vertebroplasty,PVP）对老年人多次骨质疏松性椎体压缩性骨折（osteoporosis vertebral compression fracture,OVCF）的疗效。方法回顾性分析本院2009年7月～2013年9月47例患者的资料,均有2次以上骨质疏松性椎体压缩性骨折的病史,均接受了经皮椎体成形术和规范抗骨质疏松药物治疗。采用视觉模拟评分法（visual analogue scale,VAS）评估入院时和椎体成形术后（术后即刻,术后1天、1周、1月,末次随访）的情况,采用改良Macnab标准评定临床疗效。结果所有患者病椎均穿刺成功,手术时间30～87min,平均43min。注入骨水泥的量平均为3.5ml（2～6ml）。所有患者术后腰背部疼痛均明显缓解或消失,次日佩戴腰围能独立行走。患者术后不同时期的VAS评分与术前比较差异均有显著性意义（P〈0.01）。根据改良Macnab疗效评定标准,优良率为95.74%。随访3～48个月,末次随访患者骨折椎体疼痛无复发。结论经皮椎体成形术治疗老年人多次骨质疏松性椎体压缩性骨折具有创伤小、恢复快、并发症少的特点。

Objective To investigate the curative effects of the percutaneous vertebroplasty in the elderly multiple osteoporotic vertebral compression fractures. Methods 47 cases of our hospital from Jul 2009 to Sep 2013 were retrospectively analyzed,who had two or more times history of osteoporotic vertebral compression fractures,accepted percutaneous vertebroplasty and standard anti-osteoporosis drug therapy. Used a visual analogue score assessment at admission and after vertebroplasty, at last follow-up according to the modified Macnab criteria for the assessment of clinical efficacy. Results All the patients were successfully punctured. Operation time was 30～87 min,average 43 min.Injection of bone cement volume averaged 3.5ml（2～6ml）. All patients＇ postoperative back pain were relieved or disappeared. All patients weared waistline at the next day could walk independently. Different periods of postoperative compared with the preoperative, VAS scores had significant difference（P〈0.01）. According to the modified Macnab criteria,the excellent and good rate was 95.74%. Followed-up for 3 to 48 months,the last follow-up of patients with vertebral fracture pain were without recurrence. Conclusion Percutaneous vertebroplasty for osteoporotic elderly patients with multiple vertebral compression fractures has the characteristics of less trauma,quicker recovery and fewer complications.