经皮椎体后凸成形术联合唑来膦酸治疗绝经期妇女骨质疏松性椎体压缩性骨折

Analysis of Postmenopausal Women with Osteoporotic Vertebral Compression Fractures Treated by Percutaneous Kyphoplasty Combined Zoledronic Acid

目的：探讨经皮椎体后凸成形术联合唑来膦酸（密固达）治疗绝经期妇女骨质疏松性椎体压缩性骨折的临床疗效。方法：回顾我科收治的120例绝经期妇女骨质疏松性椎体压缩性骨折,经X片、CT、MRI证实存在脊柱椎体压缩性骨折,经双能X线吸收测定法推测骨质疏松的程度。其中96例新鲜骨折均行经皮椎体后凸成形术（双侧）手术。术后第三天给予密固达5 mg（100 m L）静滴。对96例患者术前、术后1周、末次随访术前VAS评分、功能障碍指数（ODI）、JOA评分进行比较。结果：94例患者得以随访,随访时间为术后3月~36月,平均24月。16例出现不同程度的骨水泥渗漏,渗漏部位为椎体前缘或椎间隙。术后一周,末次随访的VAS、JOA评分和ODI与术前比较,差异有统计学意义（P值均小于0.00）。末次随访与术后一周比较无统计学意义（P值分别为0.18、0.49、0.50）。结论：PKP联合唑来膦酸治疗绝经期妇女骨质疏松性椎体压缩性骨折具有安全、有效、持久等优势。

T Objective： To explore postmenopausal women with osteoporotic vertebral compression fractures Treated by Percuta- neous kyphoplasty Combined Zoledronic Acid. Methods： Review of 120 cases who were postmenopausal women with osteoporotic vertebral compression fractures confirmed by X-rays, CT, MRI and speculated the degree of osteoporosis by DEXA （dual energy X-ray absorptiometry） were admitted in our departments. All of cases underwent PKP（bilateral） surgery were fxesh fractures. Aclasta is given to 5mg （100 mL） infusion after postoperative three days. On 96 patients before surgery, after surgery one week before the end of follow-up surgery VAS score, functional disability index （ODI）, JOA score were compared. Results： All of patients were followed up 3 to 36 months, an average of 24 months. 16 cases of varying degrees of bone cement let out, seepage or parts of the vertebral disc space. Compared postoperative week, the last follow-up with surgery by VAS, JOA score and ODI, the difference was statistically significant （P values were less than 0.00）, whereas, the first two had no statistically significant （P values were 0.18,0.49,0.50）. Conclusion： Postmen- opausal women with osteoporotic vertebral compression fractures treated by percutaneous kyphoplasty combined Zoledronic Acid has some advantages, such as safe, effective lasting and so on.