单侧经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的疗效分析

Efficacy of unilateral percutaneous kyphoplasty for senile osteoporotic thoracolumbar vertebral compression fractures

目的探讨单侧经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的临床疗效。方法选取2018年1月至2021年2月中国人民解放军南部战区空军医院收治的老年骨质疏松性胸腰椎压缩性骨折患者67例为研究对象,患者均采用单侧经皮椎体后凸成形术治疗,比较患者手术前后疼痛视觉模拟评分法(visual analogue scale,VAS)评分、伤椎椎体高度、Cobb角变化,评价骨水泥注入量与术后2d椎体高度恢复值和疼痛VAS评分的相关性。结果所有患者手术顺利完成,平均手术时间(31.5±10.8)min,骨水泥注入量(4.7±0.9)ml。随访6~24个月,无症状复发及椎体高度严重丢失者,未发现相邻椎体再骨折病例。5例患者术中发生骨水泥渗漏。术后2d、术后6个月及术后12个月患者的VAS评分、Cobb角均显著低于术前(P<0.05),椎体高度均显著高于术前(P<0.05)。骨水泥注入量与术后2d椎体高度恢复值和疼痛VAS评分均无显著相关性(P>0.05)。结论单侧经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折效果明显,术后患者疼痛明显缓解,椎体高度恢复良好,后凸畸形矫正满意。

Objective To investigate the clinical effect of unilateral percutaneous kyphoplasty(PKP)for senile osteo-porotic thoracolumbar vertebral compression fractures.Methods A total of 67 patients with senile osteoporotic thora-columbar vertebral compression fractures admitted to Southern Theater Air Force Hospital of PLA from January 2018 to February 2021 were selected as the research objects.All patients were treated with unilateral PKP.The changes of visual analogue scale(VAS)score,vertebral height and Cobb angle were compared before and after operation,and the correlation between bone cement injection amount and postoperative 2 days vertebral height recovery value and pain VAS score were evaluated.Results The operations were all successful,with an average operating time of(31.5±10.8)min,and an average amount of bone cement injected of(4.7±0.9)ml.The patients were followed up for 6-24 months without symptomatic recurrence or severe loss of vertebral height,and there was no case of refracture of adjacent vertebral body.Bone cement leakage occurred in 5 cases without obvious neurological symptoms.VAS score and Cobb angle at 2 days,6 and 12 months after operation were significantly lower than those before operation(P<0.05),and vertebral height was significantly higher than that before operation(P<0.05).There was no significant correlation between the amount of bone cement injection and the postoperative 2 days vertebral height recovery value and pain VAS score(P>0.05).Conclusion Unilateral PKP for the treatment of senile osteoporotic thoracolumbar vertebral compression fractures has obvious effects.Postoperative pain is significantly relieved,vertebral height is well recovered,and kyphosis correction is satisfactory.