经皮骨水泥椎间盘成形术在老年性椎间盘突出症中的应用

Application of percutaneous cement discoplasty for senile lumbar disc herniation

目的:探讨经皮骨水泥椎间盘成形术(PCD)在老年性椎间盘突出症(LDH)中的临床应用价值。方法 :回顾性分析老年性LDH患者24例(共33个椎间盘),均行PCD治疗[仅行PCD治疗18例,行经皮椎体成形术(PVP)+PCD治疗6例]。对比手术前后视觉模拟评分法(VAS)、Oswestry功能障碍指数(ODI)评分的变化,评价LDH患者的疼痛及功能改善情况,并评估疗效。结果:24例患者手术成功率为100%;术后33个椎间盘高度较术前明显恢复(P<0.05);术后6例椎体滑脱较术前明显好转(P<0.05);所有患者术后24 h、1周及1、3、6个月VAS和ODI评分均明显低于术前(均P<0.05)。结论:老年性LDH在PCD治疗基础上对邻近上下椎体行PVP治疗有效,并发症发生率低;对伴发邻近椎体骨质疏松及骨折的患者也是可选方案。

Objective:To investigate the clinical application value of percutaneous cemented discplasty(PCD) in senile lumbar disc herniation(LDH). Methods:Twenty-four patients with 33 discs of senile LDH were retrospectively analyzed. 18 patients were treated with PCD alone,6 patients were treated with PCD and percutaneous vertebroplasty(PVP). The visual analog scale(VAS),and Oswestry disability index(ODI) scores were compared before and after surgery to evaluate the improvement of pain and function. The Macnab scale was used to evaluate the efficacy. Results:The success rate of the interventional operation was100%. The height of the intervertebral disc recovered significantly after operation(P<0.05). Postoperative vertebral spondylolisthesis was significantly better than before surgery(P<0.05). The VAS and ODI scores of all patients at 24 h,1 week,1 month,3months and 6 months after surgery were significantly lower than those before surgery(all P<0.05). Conclusions:PCD is an effective method for senile LDH with a low complication rate,and PVP is also an option for patients with osteoporosis and fracture of the adjacent vertebral body.