经皮椎体成形术治疗骨质疏松性椎体压缩性骨折200例的疗效分析

Treatment of osteoporotic vertebral compression fractures with percutaneous vertebroplasty:a series of 200 cases

目的观察经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩性骨折(VCFs)的临床疗效。方法选取该院采用PVP治疗200例(256椎)VCFs患者资料,根据术前、术后疼痛评分及活动能力的改善情况、骨水泥注入量、随访情况,分析临床疗效与再骨折和骨水泥注入量的关系。结果所有患者术后疼痛明显减轻,术前视觉模拟评分法(VAS)评分(9.84±0.30)分,术后第3天为(2.13±0.85)分;活动力水平增加,术前(3.92±0.28)分,术后第3天(1.08±0.27)分;骨水泥注入量每椎(4.79±1.42)mL,无严重并发症。平均随访39.4个月,随访期间有8例患者再次骨折入院治疗,骨水泥注入量每椎(4.70±1.16)mL,与256个椎体注入量比较差异无统计学意义(P>0.05)。结论 PVP临床止痛效果与再次骨折和骨水泥注入量无明显关系;术后活动能力明显改善,与骨水泥注入量有相关性;建议规范治疗骨质疏松症。

Objective To observe the clinical effect of percutaneous vertebroplasty （PVP） in the treatment of osteoporotic vertebral compression fractures （VCFs）. Methods From March 2009 to August 2012,200 consecutive patients （256 vertebral bodies）who suffered from VCFs had been performed percutaneous vertebroplasty. Patient surveys were used to assess pain relief, improvement in mobility pre-and post-operative,the correlation between the effect and the amount of bone cement were analyzed. Patients were followed up. Results All patients with postoperative pain was significantly relieved. VAS score was 9.84±0.30 preoperative, 2.13±0.85 after the operation. The level of activity was increased, the preoperative was 3.92 ± 0.28,1.08 ± 0.27 after the operation,the amount of bone cement was（4.79 ±1.42）mL, without serious complication. The average follow-up period was 39.4 months,and 8 patients were admitted to hospital again. The aumount of bone cement was（4. 70± 1.16）mL, compured with 256 vertebral bodies,there was no statistically significant（P〉0.05）. Conclusion There was no significant relationship between the clinical pain relief effect and re-fracture and bone cement injection volume, and the postoperative activity was significantly improved, and there was a correlation between the activity and the amount of bone cement injection.