经皮椎体后凸成形术在骨质疏松性胸腰椎骨折中的应用

Percutaneous kyphoplasty in the treatment of thoracolumbar osteoporotic vertebral compression fractures

目的探讨经皮椎体后凸成形术（PKP）治疗骨质疏松性胸腰椎骨折的方法及疗效。方法回顾性分析2009年2月~2013年11月收治的胸腰椎骨质疏松性椎体压缩性骨折患者83例共95个椎体,均采用经椎弓根单侧或双侧PKP的方法进行治疗,并对术后病椎椎体前缘的高度恢复值、视觉模拟评分（VAS）和Oswestry评分的疼痛改善情况、骨水泥的渗漏情况进行了分析。结果 83例术后均获得平均16个月（6~40个月）的随访,95个椎体均穿刺成功,手术效果均满意。术后VAS和Oswestry疼痛评分较术前均明显缓解（P〈0.01）,椎体前缘高度明显改善（P〈0.01）;手术的主要并发症为骨水泥渗漏,总体发生率为43%,但并未引起患者不适症状。结论 PKP手术是一种安全、方便、有效的治疗骨质疏松性椎体压缩性骨折的方法。

Objective To discuss the methods and effects of percutaneous kyphnplasty （ PKP） in the treat-ment of thoracolumbar osteoporotic vertebral compression fractures （ OVCF） .Methods Retrospective analysis was made on 95 vertebrae in 83 thoracolumbar OVCF patients undergoing unilateral or bilateral PKP from Feb .2009 to Nov.2013.The anterior heights of the vertebra ,VAS and Oswestry score before and after operation ,and the rate of cement leakage were recorded and analyzed . Results All the 83 patients were followed up for an average of 16 months （range,6-40 months）.The 95 vertebrae were treated successfully .All patients were satisfied with the treat-ment.According to VAS and Oswestry score,the pain was alleviated obviously after the operation （P〈0.01） and the anterior heights of the vertebrae were improved remarkably （ P〈0.01 ） .The leakage of the cement was the main complication and the overall rate of the leakage was 43%,but the patient had no discomfort .Conclusion PKP is a safe,convenient and effective method for treating OVCF .