聚甲基丙烯酸甲酯骨水泥椎体成形修复老年骨质疏松性椎体压缩骨折

Vertebroplasty with polymethyl methacrylate bone cement repairs elderly osteoporotic vertebral compression fractures

背景:经皮穿刺椎体成形骨水泥注射治疗具有微创、时间短、可有效恢复椎体高度、防止椎体进一步塌陷、止痛效果明显等优点,成为治疗老年骨质疏松性压缩骨折的有效方法。目的:观察老年骨质疏松性压缩骨折经皮椎体成形骨水泥注射的治疗效果。方法:纳入62例骨质疏松性胸腰椎压缩骨折患者,其中男22例,女40例,年龄55-92岁,累及86椎体,均在C形臂X射线机透视下行经皮椎体成形聚甲基丙烯酸甲酯骨水泥注射治疗。治疗后随访12-36个月,对比治疗前后的目测类比评分、Cobb角与Oswestry功能障碍指数评分。结果与结论:治疗后随访12-36个月,11例出现并发症,其中骨水泥渗漏7例,临近椎体骨折2例,骨水泥拖尾1例,疼痛缓解不理想1例;末次随访的Cobb角、目测类比评分、Oswestry功能障碍指数评分均较治疗前显著改善(P<0.05)。表明椎体成形聚甲基丙烯酸甲酯骨水泥注射治疗老年骨质疏松性压缩骨折,不仅能恢复伤椎外形、减少后凸畸形、重建脊柱稳定性,而且能明显减轻骨折所致疼痛,改善患者生活质量,短中期疗效肯定。

BACKGROUND： Percutaneous vertebroplasty with bone cement injection has the advantages of minimal invasion,short time,effectively restoring vertebral body height,preventing further collapse of the vertebral body and obvious analgesic effect,which has became an effective method for the treatment of elderly osteoporotic compression fractures. OBJECTIVE： To observe the therapeutic effect of percutaneous vertebroplasty with bone cement injection on elderly osteoporotic compression fractures. METHODS： Sixty-two patients with osteoporotic thoracolumbar vertebral compression fracture,including 22 males and 40 females,aged 55-92 years,involving 86 vertebrae,were included and subjected to percutaneous vertebroplasty with polymethyl methacrylate bone cement injection under C-arm X-ray fluoroscopy. During the postoperative follow-up of 12 to 36 months,visual analogue scale scores,Cobb angle and Oswestry disability index scores were compared before and after the treatment. RESULTS AND CONCLUSION： At 12 to 36 months after treatment,there were 11 cases of complications,including 7 cases of bone cement leakage,2 cases of adjacent vertebral fractures,1 cases of bone cement tailing and 1 case of unsatisfactory pain relief. In the final follow-up,Cobb angle,visual analogue scale scores,Oswestry disability index scores were significantly improved compared with those before treatment（P〈0.05）. Theseresults demonstrate that percutaneous vertebroplasty with polymethyl methacrylate bone cement injection in the treatment of elderly osteoporotic compression fractures can not only restore vertebral shape,reduce kyphosis,reconstruct spinal stability,but also significantly reduce the pain caused by fractures and improve the life quality of patients. The curative effects in short and medium term are positive.