球囊扩张法在治疗骨质疏松性椎体压缩骨折中的应用

The Application of Balloon Dilation Percutaneous Vertebroplasty in the Treatment of Osteoporotic Vertebral Compression Fractures

目的:总结球囊扩张经皮椎体后凸成形术在治疗老年性骨质疏松性椎体压缩骨折中的临床效果及经验。方法:回顾性分析2009年5月-2014年5月应用经皮后凸成形术治疗的胸腰椎压缩骨折患者65例(78个椎体)的临床资料,包括手术前后VAS评分、手术前后凸Cobb氏角。结果:术后所有患者腰背疼痛完全消失或明显减轻,VAS评分由术前平均(8.2±l.2)分降为术后(1.9±1.3)分,终末随访为(2.4±1.2)分;术前Cobb角(23.8±3.5)°,术后恢复为(16.9±4.3)°,终末随访为(18.5±3.8)°。无感染,无循环及呼吸系统等严重并发症,2例术中发生少量骨水泥渗漏至椎体旁,其中1例出现胸肋部刺激性疼痛加重,其余经术中及术后长期观察,未造成任何神经及血管并发症。结论:球囊扩张经皮后凸成形术在治疗胸腰椎骨质疏松性骨折中有确切缓解疼痛及恢复椎体高度和形态的作用,是一种安全、有效的治疗方法。

Objective：To summary the clinical effect and experience of balloon dilation percutaneous kyphoplasty（PKP）in the treatment of aged osteoporosis vertebral compression fractures（OVCFs）.Method：From May 2009 to May 2014,65 0VCFS patients（78 vertebrae）underwent balloon dilation PKP were retrospectively analyzed,including the visual analogue scale（VAS）score as well as Cobb S angle of the vertebrae preoperatively and postoperatively.Result：The back pain mall patients completely disappeared or relieved obviously postoperatively.The VAS score improved from（8.2±1.2）points preoperative down to（1.9±1.3）points postoperative,the terminal follow-up（2.4±1.2）points,while Cobbl S angle decreased from（23.8±3.5）° preoperative back to（16.9±4.3）° postoperative,the terminal follow-up to（18.5±3.8）°.The complications such as infections,circulatory and respiratary disorders did not occure except the leakage of PMMA m two patients,of which one patient occurred the irritating pain.In stemocostal part,other two did not cause any nervous and vascular complications either during the operation or in a long period after operation.Conclusion：The balloon dilation PKP has exact efficacy on relieving back Dain and restore the height and shape of vertebrae and it is a safe and effective method in the treatment of aged osteoporosis vertebral compression fraawes.