椎体成形术在骨质疏松性椎体骨折不愈合中的应用

Percutaneous Vertebroplasty in the Treatment of Nonunion in Osteoporotic Vertebral Compression Fracture

目的研究椎体成形术治疗骨质疏松性椎体骨折（osteoporotic vertebral compression fracture，OVCF）不愈合的疗效。方法自2009年1月至2014年1月采用椎体成形术治疗Ⅰ、Ⅱ期OVCF不愈合患者30例，共36个伤椎，分别于术前、术后3d、1个月及终末随访时以视觉模拟评分（visual analoguescale，VAS）评估疼痛的程度、Oswestry功能障碍指数（oswestry disability index，ODI）评估活动功能受限程度，同时测量伤椎前缘高度变化。结果本组30例患者共36节椎体均成功实施椎体成形手术，无截瘫、肺栓塞等严重并发症；随访6-36个月，平均18．5个月。VAS评分、Oswestry功能障碍指数（ODI）显著下降（P〈0．05）；椎体高度术前、术后无明显差异（0．05）。结论椎体成形术是治疗Ⅰ、Ⅱ期OVCF不愈合简单、有效的方法，可有效缓解疼痛，防止椎体高度继续丢失，但无法有效恢复骨折椎体高度。

Objective To reserch the clinical efficacy of percutaneous vertebroplasty（PVP） in the treatment of nonunion in osteoporotie vertebral compression francture（OVCF）. Methods From January 2009 to January 2014,36 nonunion vertebras in all 30 patients of I, Ⅱ stage ware treated by PVP. We evaluate VAS score, Oswestry disability index （ ODI ） and anterior height（AH） of the compressive vertebral body before and after（ 3 day, 1 month and final follow-up）the operation. Results A total of 36 vertebras in all 30 patients were treated successfully by PVP procedure ; no severe complications such as paraplegia, pulmonary embolism after the operation. The patients were followed up for 6 to 36 months with an average of 18.5 months. VAS score, Oswestry disability index （ODI） improved apparently after the operation （ P 〈 O. 05 ）. But the height of compressive verte- bral body were not significant improved after the operation than those before the operation（O. 05 ）. Conclusion PVP is a sim- ple and effective method in the treatment of I, Ⅱ stage osteoporotic vertebral compression francture nonunion. It can effectively alleviates the pain, and prevent further loss of vertebral height ; but it can not increase the height of compressive vertebral body effectively.