经皮穿刺椎体成形术治疗骨质疏松椎体压缩骨折

Treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty

目的 确定经皮穿刺椎体成形术在治疗疼痛性骨质疏松脊柱压缩骨折中的效用。方法 2年内 15例有 1～ 6个月背部、腰部疼痛伴行动障碍需止痛药治疗患者 (男 5人、女 10人 ) ,年龄5 8～ 81岁 ,经临床、CT及MRI评价为骨质疏松椎体压缩且近期有进展 ,在CT引导下完成经皮穿刺椎体成形术 2 2例次。治疗效果采用Huskisson止痛视觉评分法评估。结果 13例患者 (86 7% )在2 4h内疼痛缓解 ,12例停用止痛药 ,余下的 2例有轻微疼痛好转 (13 3% )。 1例患者 3个月后由于相邻椎体出现新的压缩而疼痛复发 ,二次治疗好转。结论 经皮穿刺椎体成形术用于骨质疏松椎体压缩是一种微创操作 ,可以立即缓解疼痛并使患者很快恢复运动 。

Objective\ To determine the efficacy of percutaneous vertebroplasty (PVP) in treating painful osteoporotic vertebral compression fractures. Methods\ Fifteen cases of vertebral compression fracture were evaluated with CT and MRI to determine osteoporotic origin and recent evolution. Twenty\|two percutaneous vertebroplasties were performed using CT guidance. The fifteen patients included in the study (5 men, 10 women; 58-81 years old) had had pain for one to six months that hindered ambulation and required treatment with narcotic drugs. The analogic visual scale of Huskisson was used for pain in scoring assessment. Results\ In 13 patients (86\^7%), pain relief was complete within 24 hours after bone cement injection. Analgesic administration was stopped in 12 patients. Pain relief was slight in the other 2 patients. In the last patient, pain recurred three months after PVP because of a new acute collapse of an adjacent vertebra. It was relieved by a second PVP. Conclusion\ Vertebroplasty for the treatment of osteoporotic vertebral compression fracture is a minimally invasive procedure that provides immediate pain relief and enables the patients to become quickly mobile. PVP is a good method to treat osteoporotic vertebral collapse.