椎体后凸成形术治疗骨质疏松性双凹形椎体骨折

Kyphoplasty for Osteoporotic Vertebral Biconcave-Shaped Fractures

目的探讨椎体后凸成形术治疗骨质疏松性双凹形椎体骨折临床及影像学疗效。方法回顾性分析2014年1月-2015年1月苏州大学附属第一医院骨科收治的行椎体后凸成形术治疗骨质疏松性双凹形椎体骨折患者25例，术前、术后、末次随访采用视觉模拟评分法（VAS）、Oswestry功能障碍指数（ODI）及影像学评估患者疼痛、功能状态及椎体高度、局部后凸畸形等。结果所有患者均获得随访，且资料完整，患者术前疼痛VAS为（8.3±1．2），术后为（2．1±0．8），疼痛明显改善（P〈0．05），末次随访时患者疼痛评分仍维持在较低水平；患者术后ODI评分较术前明显改善，患者生活质量明显改善，末次随访时患者ODI仍显著低于术前。椎体前部高度在术后及末次随访时，与术前比较差异均无统计学意义（P〉0．05）；局部后凸角也是类似。但椎体中部高度在术前及末次随访时与术前比较差异具有统计学意义（P〈0．05）。结论椎体后凸成形术能有效改善骨质疏松性双凹形椎体骨折的疼痛及生活质量，恢复椎体形态。

Objective To observe the effect of kyphoplasty （KP） in treating osteoporotic vertebral biconcave- shaped fractures. Methods In this retrospective study, 25 patients with osteoporotic vertebral biconcave-shaped fractures were treated by KP from Jan 2014 to Jan 2015. The heights of the compromised vertebral body and the kyphotic angles were measured before surgery, after surgery, and at the final follow-up. Visual analogue scale （VAS） and Oswestry Disability Index （ODI） were used to evaluate pain and functional activity, respectively. Results The mean VAS and ODI scores improved significantly from pre- to post-operation （P 〈 0.05）, and this improvement was sustained at the final follow-up. There is no difference of the anterior vertebral height between after surgery, at final follow-up and before surgery （P 〉 0.05）. It＇s a similar change of kyphotic angle. There is difference of the middle vertebral height between after surgery, at final follow-up and before surgery （P 〈 0.05）. Conclusion KP achieved improvements in pain and functional outcomes for the treatment of osteoporotic vertebral biconcave- shaped fractures. KP can restore the shape of vertebral body.