球囊扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩性骨折合并急性或亚急性脑梗死患者的效果

Effect of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fracture complicated with acute or subacute cerebral infarction

目的探讨球囊扩张椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩性骨折合并急性或亚急性脑梗死患者的效果。方法回顾性分析2013年6月至2017年12月收治于郑州大学第一附属医院骨科五病区的老年骨质疏松性椎体压缩性骨折合并不同程度急性或亚急性脑梗死的患者行PKP并获得术后随访的病例共48例,均于局麻加心电监护下行PKP手术治疗。结果术后当日所有患者疼痛症状即明显减轻或消失,术后次日即可带软质腰围下床自主活动。术后无脑梗死加重情况。所有患者均得到随访,随访时间3~15个月。术前与术后患者模拟视觉疼痛评分(VAS)、椎体前后缘高度比值、脊柱后凸角度比较,差异有统计学意义(均P<0.05)。结论应用微创球囊扩张椎体后凸成形术治疗合并急性或亚急性脑梗死的老年骨质疏松性椎体压缩性骨折患者可以较短时间内缓解疼痛,有效恢复椎体高度,改善后凸畸形,并在后期随访中疗效稳定,同时并不增加脑梗加重风险。

Objective To investigate the effect of balloon kyphoplasty (PKP) in the treatment of osteoporotic vertebral compression fracture complicated with acute or subacute cerebral infarction. Methods Retrospective analysis of PKP in elderly patients with osteoporotic vertebral compression fractures and different degrees of acute or subacute cerebral infarction admitted to the Department of Orthopaedics in the First Affiliated Hospital of Zhengzhou University from June 2013 to December 2017, 48 cases inconcluded, PKP surgery was performed with local anesthesia plus ECG monitoring. Results On the day after surgery, all patients’ pain symptoms were alleviated or disappeared. The next day after surgery, they could take a soft waist and get out of bed. There was no worsening of cerebral infarction after operation. All patients were followed up for 3 months to 15 months. Preoperative and postoperative patients with simulated visual pain score (VAS), vertebral body anterior border height ratio, kyphosis angle difference were statistically significant(all P < 0.05). Conclusion Minimally invasive balloon kyphoplasty for the treatment of elderly patients who suffer from osteoporotic vertebral compression fractures with acute or subacute cerebral infarction can relieve pain in a short period of time, effectively restore vertebral height and improve kyphosis, the efficacy is stable during the follow-up, and does not increase the risk of cerebral infarction.