48例经皮单侧椎体成形术治疗骨质疏松性胸腰椎骨折的临床分析

Clinical Analysis of Percutaneous Vertebroplasty in 48 Patients with Osteoporosis Thoracolumbar Fracture

目的:观察经皮单侧椎体成形手术(PVP)治疗骨质疏松伴病理性胸腰椎骨折的临床疗效.方法:针对在我院采用PVP手术治疗的骨质疏松性胸腰椎压缩骨折患者48例,术中调整DSA机C型臂,拍摄骨折椎体标准正位透视像;行骨折椎体侧位透视,选定进针的角度及方向,经椎弓根外上象限左侧3点,右侧9点处进针,分析病人手术前后腰背部疼痛改善情况.结果:实行椎体成形术后1天内有32例患者病椎周围疼痛全部消失,有14例患者腰背部疼痛情况得到显著缓解.影像学显示术前椎体前缘压缩后程度在50~77%之间,椎体中央压缩后程度在60~88%之间;术后椎体前缘压缩后程度在52~73%之间,椎体中央压缩后程度在50~84%之间,与术前比较差异有统计学意义(P<0.05).结论:骨质疏松伴胸腰椎病理性骨折疾病采用PVP治疗,疗程短、卧床时间少,手术创伤小、操作不复杂,且获得治疗效果比较满意.值得在临床治疗上采用.

Objective:To observe the clinical effect of percutaneous vertebroplasty(PVP)in the treatment of osteoporosis with pathological thoracolumbar fractures.Methods:48 patients with osteoporotic thoracolumbar vertebral compression fractures treated by PVP were treated.DSA C arm was adjusted during operation to take standard orthogonal fluoroscopy of fracture vertebral body.Lateral fluoroscopy of fracture vertebral body was performed to select the angle and direction of needle insertion.The needle was inserted at 3 points on the left side of the lateral upper quadrant of pedicle and 9 points on the right side.The improvement of lumbar back pain before and after operation was analyzed.Result:Within one day after vertebroplasty,32 patients’perivertebral pain disappeared completely,and 14 patients’back pain was relieved significantly.Imaging showed that the degree of anterior vertebral compression was between 50-77%and that of central vertebral compression was between 60-88%.The degree of anterior vertebral compression was between 52-73%and that of central vertebral compression was between 50-84%.The difference was significant(P<0.05).Conclusion:The treatment of osteoporosis with pathological fracture of thoracolumbar spine with PVP has the advantages of short course of treatment,less time in bed,less trauma and complicated operation,and satisfactory therapeutic effect.It is worth using in clinical treatment.