经皮穿刺椎体成形术治疗骨质疏松性椎体骨折不愈合

Observation and analysis of PVP treatment of osteoporotic vertebral fracture nonunion

目的研究经皮穿刺椎体成形术（PVP）在骨质疏松性椎体骨折（OVCF）不愈合的应用价值。方法选取38例OVCF不愈合患者的46个病变椎体接受PVP治疗，比较患者不同时段的疼痛视觉模拟评分（VAS）及日常生活自理能力量表（ADL）评分。结果手术均成功进行，术中发生骨水泥沿椎体静脉丛渗漏1例，骨水泥沿破裂椎体前缘渗漏1例，未发生其它严重并发症。所有患者在接受手术后2 d内疼痛情况均得到较好缓解，术前疼痛VAS评分为（7.1±1.2）分，术后2 d为（2.3±0.6）分，术后3个月为（1.9±0.7）分，术后6个月为（1.2±1.1）分，差异均有统计学意义（P〈0.05）。术后6个月ADL评分[（78.0±10.0）分]较术前[（40.0±12.0）分]明显改善，差异有统计学意义（P〈0.05）。患者术后随访未见疼痛加重，病椎未见再发骨折。结论PVP治疗骨质疏松性椎体骨折不愈合，疗效可靠，能够缓解疼痛，从而改善患者生活质量，值得临床选择应用。

ObjectiveTo study the value of percutaneous vertebroplasty （PVP） in nonunion of osteoporotic vertebral fractures （OVCF）.MethodsThirty-eight OVC non-union patients were selected for treatment of 46 lesions with PVP. The pain visual analogue scale （VAS） and daily living self-care ability scale （ADL） scores of patients at different time were compared.ResultsThe operation was successfully performed. One case of leakage of cement along the vertebral venous plexus and one case of leakage of bone cement along the anterior edge of the ruptured vertebral body occurred during the operation. No other serious complications occurred. All patients received better pain relief within 2 days after surgery. The VAS score was （7.1±1.2）, preoperative pain VAS score was （2.3±0.6）, postoperative 3 months was （1.9±0.7）, and 6 months after operation was （1.2±1.1）, the differences were significant （P〈0.05）. The ADL score [（78.0±10.0） points] 6 months after operation was significantly improved compared with preoperative [（40.0±12.0） points], the difference was significant （P〈0.05）. No postoperative follow-up of patients with pain, no recurrence of vertebral fracture fractures.ConclusionsPVP treatment of osteoporotic vertebral fracture nonunion, reliable, can relieve pain, thereby improving the quality of life of patients, it is worth the clinical choice and application.