经皮椎体成形术治疗合并帕金森病胸腰椎骨质疏松性椎体压缩骨折病人的疗效观察

Effectiveness of percutaneous vertebroplasty for Parkinson’s disease with thoracic and lumbar osteoporotic vertebral compression fracture

目的观察经皮椎体成形术(percutaneous vertebroplasty,PVP)治疗帕金森病病人发生骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效。方法2019年6月~2021年5月在我院收治的合并帕金森病胸腰椎OVCF病人12例,进行PVP治疗,均采用经椎弓根外入路,单侧穿刺17个,补充对侧穿刺5个。结果所有病人均顺利完成手术。术后3天VAS评分为(1.67±0.78)分,ODI为(38.50±10.73)%,均较术前明显改善,差异有统计学意义(P<0.05);受累节段椎体前缘高度为(11.09±0.83)mm,椎体后凸角为(17.38±3.97)°,与术前比较,差异有统计学意义(P<0.05)。术后3个月随访,手术椎体未再发生骨折及塌陷,未发现相邻节段骨折。术后12周,VAS评分为(1.58±0.52)分,ODI为(37.08±7.46)%,受累节段椎体前缘高度为(11.18±0.98)mm,椎体后凸角为(18.55±3.73)°,与术后3天比较均无统计学差异(P>0.05)。结论合并帕金森病胸腰椎OVCF病人,行经椎弓根外侧入路PVP治疗,疗效满意。

Objectives To observe the therapy effectiveness of percutaneous vertebroplasty for Parkinson’s disease with thoracic and lumbar osteoporotic vertebral compression fracture.Methods 12 patients of Parkinson’s disease with thoracic and lumbar OVCF treated by PVP between June 2019 and May 2021 were analyzed in the department of spinal surgery of our hospital.Extrapedicular approach was used in all cases,but unilateral puncture to 17 vertebral body and additional opposite puncture to 5 vertebral body.Results Surgery of 12 patients was conducted smoothly.Three days after operation,VAS of back pain was 1.67±0.78,ODI was(38.50±10.73)%,which all showed significant differences(P<0.05).Height of anterior margin of affected segment vertebral body was(11.09±0.83)mm,Kyphosis of the vertebral body was(17.38±3.97)°,which showed obvious improvement too(P<0.05).During the follow-up for 3 months,new fracture and collapse could not be found either in diseased level or adjacent level.At 12 weeks follow-up,VAS of back pain was(1.58±0.52),ODI was(37.08±7.46)%,AH was(11.18±0.98)mm,KA was(18.55±3.73)°,which remained no statistical difference compared with those of three days after operation(P>0.05).Conclusions For Parkinson’s disease with thoracic and lumbar OVCF,PVP with extrapedicular approach was used in 12 cases and achieved satisfactory therapy effects in this article.