经皮椎体成形术治疗骨质疏松性椎体压缩骨折

Percutaneous vertebroplasty for treatment of osteoporotic vertebral compression fractures

目的探讨经皮椎体成形术(PVP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法对221例OVCF患者(270个椎体)行PVP治疗。采用疼痛VAS评分对腰背部疼痛变化进行评估,采用Barthel指数对日常生活活动能力恢复情况进行评估。结果患者均获得随访,时间3~12个月。患者均未发生肺栓塞、骨水泥过敏等严重并发症。46例(51个椎体)发生不同程度骨水泥渗漏。患者术后疼痛均得到有效缓解,VAS评分术前为4~9(7.2±1.6)分,术后第3天为1~3(2.0±0.4)分,术后3个月为1~4(2.2±0.5)分。Barthel指数术前为29~51(41.3±6.4)分,术后第3天为72~95(83.4±6.1)分,术后3个月为68~91(81.9±6.3)分。与术前比较,术后第3天和术后3个月的VAS评分均显著降低(P<0.05),而Barthel指数则显著升高(P<0.05)。结论PVP治疗OVCF能迅速缓解疼痛、稳定脊柱,改善生活质量,而且损伤小,是一种安全有效的治疗措施。

Objective To investigate the clinical effect of percutaneous vertebroplasty(PVP)for osteoporotic vertebral compression fractures(OVCF).Methods The 270 vertebrae of 221 OVCF patients were treated with PVP.The changes of back pain were evaluated by pain VAS,and the recovery of activities of daily living was evaluated by Barthel index.Results All patients were followed up for 3~12 months.No serious complications such as pulmonary embolism and bone cement allergy occurred.There were 46 cases(51 vertebrae)with different degrees of bone cement leakage,and the pain was effectively relieved after operation.The VAS was 4~9(7.2±1.6)points before operation,1~3(2.0±0.4)on the third day after operation and 1~4(2.2±0.5)points at 3 months after operation.The Barthel index was 29~51(41.3±6.4)points before operation,72~95(83.4±6.1)points on the third day after operation and 68~91(81.9±6.3)points at 3 months after operation.The VAS of 3 d and 3 months after operation were significantly decreased than those before operation(P<0.05),while the Barthel index was significantly increased(P<0.05).Conclusions PVP for treatment of OVCF,which can rapidly relieve pain,stabilize the spine,improve the quality of life,and has less trauma,is a safe and effective treatment.