经皮椎体成形术治疗多发性骨质疏松性椎体压缩骨折的疗效

Clinical outcome of percutaneous vertebroplasty for treatment of multisegments osteoporotic vertebral compression fractures

目的探讨经皮椎体成形术(PVP)治疗多发性骨质疏松性椎体压缩骨折(OVCF)的安全性及有效性。方法对31例多发性OVCF的老年患者(106个椎体)行PVP治疗。采用疼痛VAS评分评价临床疗效;观察并发症情况。结果 1例患者因术中透视不佳未能完成手术,30例患者顺利完成手术。30例均随访3个月。术后患者疼痛明显减轻,术后、术后1个月、术后3个月VAS评分与术前比较差异均有统计学意义(P <0. 05)。4例术后复查CT发现骨水泥椎管少许渗漏,均未见神经压迫症状; 1例出现肋间神经痛,给予营养神经等对症处理,1个月后症状消失; 3例出现骨水泥向椎间隙少许渗漏,6例出现骨水泥向椎旁软组织少许渗漏,术后均未见明显症状。结论 PVP治疗多发性OVCF安全、有效。

Objective To explore the safety and efficacy of percutaneous vertebroplasty (PVP) in treatment of multiple osteoporotic vertebral compression fractures(OVCF). Methods The 31 cases (106 vertebrae) who sustained OVCF and underwent PVP. The clinical efficacy was evaluated by pain VAS,and the complications were observed. Results One patient failed to complete the operation due to poor intraoperative fluoroscopy, and thirty patients successfully completed the operation. Thirty patients were followed up for 3 months. Postoperative pain was significantly relieved. VAS at the postoperation, 1 month, 3 months after operation were significantly different from those before operation ( P< 0.05). Four cases of bone cement spinal canal leakage were found by CT, and no nerve compression symptoms were found. There was 1 case of intercostal neuralgia who was treated with nutritional nerve, and symptoms disappeared after 1 month. There were 3 cases with slight leakage of bone cement intervertebral space and 6 cases with slight leakage of bone cement paravertebral soft tissue. No obvious symptoms were found after operation. Conclusions PVP is a safe and effective procedure for the treatment of OVCF in elderly patients.