经皮椎体成形术治疗36例骨质疏松性椎体压缩性骨折的经验

The percutaneous vertebroplasty on osteoporotic vertebral compression fracture:an experience of 36 cases

目的分析经皮椎体成形术（PVP）治疗骨质疏松性椎体压缩性骨折（OVCF）的疗效。方法对2011年1月至2014年6月在我院应用PVP治疗的36例单椎体骨折病例进行回顾分析,患者平均年龄74岁。从疼痛程度变化、伤椎压缩率、后凸角、并发症发生情况进行评价。结果术后24小时所有患者腰背疼痛均显著缓解,VAS评分较术前明显下降,术后各时间点与术前比较均存在统计学差异（P〈0.001）。压缩率及后凸角术前、术后各时间点之间比较均无统计学差异。4例存在无症状椎体外骨水泥渗漏。所有病例至今获随访24-42个月,平均33个月。4例于术后2年内出现腰背部疼痛症状,经X线证实为邻近椎体新发骨折;余患者无疼痛复发,无原有症状加重或神经受压症状出现,伤椎及邻近椎体形态未发生明显变化。结论对任何年龄段的OVCF,采用积极的PVP有利于减轻患者痛苦,而且安全。

Objective To evaluate the effect of percutaneous vertebroplasty（PVP） on osteoporotic vertebral compression fracture（OVCF）. Methods Thirty-six patients with OVCF（single vertebral fracture）from Jan 2011 to June 2014 in our hospital undergoing PVP were retrospectively analyzed. The average age of the patients was 74 years. The extent of pain was measured with visual analog scale,and the compression ratio,the kyphotic angle and the complications were also investigated.Results A remarkable pain relief was achieved within 24 hours postoperatively in all cases. Postoperative VAS values declined markedly and were statistically significantly different from preoperative values（P〈0.001）. No statistically significant differences were recorded between preoperative and postoperative values of compression ratio or kyphotic angle（P〉0.05）. Asymptomatic cement leakage was found on postoperative radiographs in four cases. All cases were followed from 24 to 42 months,33 months at average. Adjacent vertebral fractures were confirmed by X-ray in four cases within 2 years and lumbar back pain were manifested. No pain exacerbation or fresh onset of neural compression took place in the rest of patients. The form of neither the responsible vertebrae nor their adjacent vertebrae had changed.Conclusion PVP is a safe and effective method for treating OVCF.