经皮椎体后凸成形术配合密固达治疗骨质疏松性胸腰椎骨折的疗效分析

Effect of percutaneous kyphoplasty combined with intraventous Aclasta in treating osteoporotic thoracolumbar fractures

目的探讨经皮椎体后凸成形术配合密固达治疗骨质疏松性胸腰椎骨折的疗效。方法对95例骨质疏松性胸腰椎骨折的患者行经皮椎体后凸成形术（percutaneous kyphoplasty,PKP）和密固达（Aclasta）药物治疗,分别使用Oswestry功能障碍指数（oswestry disability index,ODi）和视觉模拟评分法（visual analogue score,VAS）对术前和术后临床疗效进行评价,随访时间2个月-60个月,平均32.4个月。结果手术时间为20-85 min（平均29 min）,术中累计X线透视时间平均32 s,术中出血量为5-10 mL（平均7.5 mL）,平均住院6 d,均在术后1-2 d佩戴腰围下床。术前第1天及术后1个月随访,Oswestry功能障碍指数及Vas评分结果均有显著性差异（P〈0.05）。结论经皮椎体后凸成形术配合密固达是治疗骨质疏松性胸腰椎骨折的一种创伤小、疗效肯定、有效改善患者症状和预防患者再发骨折风险的有效方法。

Objective To explore the effect of percutaneous kyphoplasty（ PKP） combined with Aclasta in freatment of osteoporotic thoracolumbar fractures. Methods A total of 95 patients with osteoporotic thoracolumbar fractures,who were treated with PKP combined with Aclasta,were enrolled in the First. The clinical records about Oswestry disability index and the visual analog score（ VAS） before and after surgery were analyzed to evaluate the clinical effects. The follow-up time was 2 months to 60 months,32. 4 months on average. Results The operation time ranged from 20 to 85min（ mean 29 min）,including mean cumulative X fluoroscopy time of 32 s. The amounts of bleeding were 5- 10 ml（ average 7. 5 ml） and the mean hospital time were 6 days. All patients got out of bed wearing waist apron 1 to 2 days after PKP. There were significant differences in the ODi and VAS before and after surgery（ P〈0. 05）. Conclusion The combination of PKP with intraventous Aclasta in the treatment of osteoporotic thoracolumbar fractures is a minimally invasive and effective method. It can improve patients symptoms and prevent recurrence of osteoporotic fractures.