经皮椎体成形术在经皮椎体成形术后骨水泥强化椎体再骨折中的应用

Application of PVP in the treatment of refracture of bone cement-reinforced vertebral bodyafter PVP after PVP

目的探讨经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗PVP术后骨水泥强化椎体再骨折的临床疗效及可行性。方法 PVP术后骨水泥强化椎体再骨折患者13例,6例再次PVP治疗,7例保守治疗。治疗后1周、1月、3月和12月进行电话随访或门诊复诊。用疼痛视觉模拟评分(VAS)及Oswestry功能障碍指数(ODI)评估治疗效果。记录VAS评分、ODI值以及有无坠积性肺炎、下肢深静脉血栓和褥疮等并发症。结果治疗后两组VAS评分和ODI值均较治疗前降低(P<0.01);治疗后1周和1月,PVP治疗组VAS评分低于保守治疗组(P<0.01);治疗后1月,PVP治疗组ODI值低于保守治疗组(P<0.01);治疗后3月和12月,两组间VAS评分和ODI值比较,差异无统计学意义(P>0.05)。所有患者随访期间无坠积性肺炎、下肢深静脉血栓形成和褥疮等并发症发生。结论PVP能够显著缓解PVP术后骨水泥强化椎体再骨折患者的临床症状,改善功能,且无明显并发症,效果满意。

Objective To investigate the clinical efficacy and feasibility of PVP in the treatment of refracture of bone cement-reinforced vertebral body after PVP.Methods In 13 patients with bone cement-enhanced vertebral body refracture after PVP,6 patients received PVP again and 7 patients accepted conservative treatment.After 1 week,1 month,3 months and 12 months of treat-ment,telephone follow-up or outpatient review was performed.The treatment effect was evaluated by using visual analogue scale(VAS)and Oswestry disability index(ODI).VAS scores,ODI values and complications such as hypoprandial pneumonia,deep venous throm-bosis of the lower extremities and decubitus were recorded.Results The VAS score and ODI value of the two groups after treatment were significantly lower than those before treatment(P<0.01).After 1 week and 1 month of treatment,VAS score and ODI value of the PVP group were remarkably lower than those of the conservative group(P<0.01).There was no significant difference in VAS score and ODI value between the two groups after 3 and 12 months of treatment(P>0.05).No complications such ashypostatic pneumonia,deep venous thrombosis of the lower extremities and decubitus occurred during follow-up.Conclusion PVP can significantly alleviate the clinical symptoms and improve the spine function of patients with bone cement-reinforced vertebral refracture after PVP operation.There are no obvious complications and the clinical effect is satisfactory.