聚甲基丙烯酸甲酯骨水泥椎体成形治疗高龄骨质疏松性胸腰椎骨折

Vertebroplasty with polymethylmethacrylate bone cement treats elderly osteoporotic thoracolumbar vertebral compression fractures

背景:目前经皮椎体成形在临床上治疗骨质疏松性椎体骨折较为广泛应用,而针对高龄患者(65岁以上)在手术的时候存在患者基础病情的限制,关于此方面的细化研究逐渐引起临床医师的重视。目的:对比分析骨水泥椎体成形治疗和常规体位复位保守治疗高龄骨质疏松性胸腰椎骨折的临床疗效。方法:对24例高龄骨质疏松性胸腰椎骨折患者采用自愿的原则分为骨水泥治疗组和保守治疗组,各12例,分别采取聚甲基丙烯酸甲酯骨水泥椎体成形和常规体位复位保守治疗。结果与结论:与保守治疗组相比,骨水泥治疗组患者目测类比评分、Oswesty功能障碍指数和椎体后凸Cobb角明显降低,而伤椎前缘压缩度增加。提示针对高龄骨质疏松性椎体骨折患者,争取稳定病情后行脊柱微创治疗,有利于改善患者的愈合和提高生活质量。

BACKGROUND：At present, percutaneous vertebroplasty has been widely used in clinical treatment of osteoporotic vertebral fractures. Considering the limitations of the underlying disease in elderly patients （〉 65 years of age） at surgery, the relevant detailed studies have gradualy attracted the attention of clinicians. OBJECTIVE：To compare and analyze the clinical effects of vertebroplasty with bone cement and conventional fracture reduction for elderly osteoporotic thoracolumbar fractures. METHODS：Totaly 24 elderly patients with osteoporotic thoracolumbar fractures were voluntarily divided into bone cement treatment and conservative treatment groups （n=12 per group） and subjected to vertebroplasty with polymethylmethacrylate bone cement and conventional reduction therapy, respectively. RESULTS AND CONCLUSION：Compared with the conservative treatment group, the visual analog scale scores, Oswesty dysfunction index and Cobb angle were significantly reduced in the bone cement treatment group, while the degree of anterior vertebral compression was increased. These results suggest that minimaly invasive spine treatment is conducive to improve the fracture healing and enhance the quality of life in elderly patients with osteoporotic vertebral compression fractures in stable conditions.