经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折疗效分析

The efficacy of percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures of older people

目的探讨经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折的方法和效果。方法回顾2014年1月—2015年6月,采用经皮椎体成形术治疗老年骨质疏松性胸腰椎压缩骨折48例(56个椎体),均为新鲜骨折,并随访6~12个月,对比术前术后疼痛评分、伤椎椎体高度、Cobb角度及功能恢复情况,并对比分析术前和术后6个月的血流变学、空腹血糖及C-反应蛋白指标。结果 48例患者术后疼痛症状均明显缓解,随访6~12个月,平均随访10.5个月,术后第2天、术后1周及术后6个月疼痛评分、伤椎椎体高度、Cobb角度及功能恢复与术前比较,P均<0.05,术后第2天、术后1周及术后6个月比较,P均>0.05;手术前与手术后6个月的血流变学、空腹血糖及C-反应蛋白比较,P均>0.05。其中有3例术中发生骨水泥渗漏,均无明显神经症状;术后随访6个月有2例发生相邻椎体压缩骨折。结论椎体成形术是治疗老年骨质疏松性胸腰椎压缩性骨折的良好方法,能够有效缓解疼痛,重建脊柱的稳定性,恢复椎体部分的高度。

Objective To investigate the method and efficacy of percutaneous vertebroplasty in the treatment of osteoporotic thoracolumbar vertebral compression fractures of older people. Methods From January 2014 to June 2015, 48 cases（56 centrum） of osteoporotic thoracolumbar vertebral compression fractures were treated by percutaneous vertebroplasty. According to 6.12 months＇ follow-up, we compared pain scores, the damaged centrum height, Cobb angle and its functional recovery before and after operation and also analyzed blood rheology, fasting blood glucose and c-reactive protein indexes before operation and 6 months after the operation. Results The pain symptoms of 48 patients were all obviously relieved after operation. The patients were followed up for 6 to 12 months with an average follow-up of 10.5 months.The pain scores, the damaged centrum height, Cobb angle and its functional recovery at the 2 nd day after operation, 1 st week after operation and 6 months after operation had statistically significant difference compared with those before operation. However, those had no statistically significant difference at the 2 nd day after operation, 1 st week after operation and 6 months after operation. There was no statistically significant difference in hemorheology, fasting blood glucose and c-reactive protein before operation and 6 months after operation. There were 3 cases having cement leakage during operation and2 cases having adjacent vertebral compression fractures during the follow-up. Conclusion Vertebroplasty is a good method for the treatment of osteoporotic thoracolumbar compression fractures in the old people, which can effectively relieve the pain, rebuild the stability of the spine and restore the height of the vertebral body.