摘要
目的 探讨单球囊与双球囊椎体后凸成形术治疗骨质疏松性椎体骨折的疗效。方法2008年4月～2010年2月，收治骨质疏松性椎体压缩骨折患者26例，累及椎体35个。随机分为单球囊组，15例，21个椎体，平均72（53～79）岁；双球囊组，11例，14个椎体。平均70．8（51～80）岁。手术于x线透视下完成，双球囊组应用双球囊在椎体内双侧同时扩张；单球囊组应用单球囊双侧穿刺在椎体内交替扩张。术后观察症状改善、椎体高度复位及后凸畸形矫正、并发症发生等情况。结果单球囊组平均每个椎体手术时间37．5（33～85）min；双球囊组平均每个椎体手术时间33．9（30～75）min；随访时间12～18个月，平均14．8个月。术后患者腰背痛症状均较术前明显缓解。VAS疼痛评分：单球囊组术前平均为7．6±2．2，术后为2．5±1．8，末次随访为3．1±2．0，手术前后差异有统计学意义（P〈O．05）；双球囊组术前平均为7．9±2．3，术后为2．4±2．0，末次随为2．9±2．1，手术前后差异有统计学意义（P〈0．05）；两组术后椎体前缘、中央高度均比术前有显著增加，且维持至末次随访，差异均有统计学意义（P〈0．05）。椎体后凸角单球囊组平均矫正（7．0°±4．5°），双球囊组平均矫正（7．7°±3．9°），各组手术前后比较，差异有统计学意义（P〈0．05）。而两组间上述各指标对应比较，差异无统计学意义。结论单球囊与双球囊椎体后凸成形术治疗老年骨质疏松性压缩骨折均可获得满意的治疗效果。
Objective To evaluate the clinical efficacy of percutaneous bipedicular kyphoplasty with double or single balloon in treatment of elderly patients with osteoporotic vertebral compression fractures（OVCFs）. Methods From April 2008 to Feb 2010, 26 patients with OVCFs involving 35 vertebrae were treated by percutaneous kyphoplasty（PKP）, and randomized to single or double balloons group. The average age of the single balloon group （ 15 patients with 21 involved vertebrae） was 72 years and that of the double group （11 patients with 14 vertebrae） was 70.8 years. Each procedure included insertion of inflatable balloon（single or double）, fracture reduction and cement filling under monitoring. Preoperative and postoperative pain levels, radiographs and complications were recorded and analyzed. Results The mean operation time were 37.5 （33~85）min and 33.9 （30~75）min for single and double balloon groups respectively. The mean follow-up duration was 14.8 （12~18）months. The mean VAS pain score of single balloon group decreased significantly from 7.6 ± 2.2 preoperatively to 2.5 ± 1.8 postoperatively （P 〈 0.05） and 3.1 ~ 2.0 at final follow-up, the mean VAS pain score of double balloon group decreased significantly from 7.9 ± 2.3 preoperatively to 2.4 ± 2.0 postoperatively （P 〈 0.05） and 2.9 ± 2.1 at final follow-up, while no significant difference in changes of VAS pain was found between two groups. Significant increase of the mean height of anterior and medial vertebral body were observed after the operation and maintained at final follow-up for both groups （P 〈 0.05）. The mean correction of local kyphosis was （7.0° ＋ 4.5°） for single balloon group and （7.7°＋ 3.9°） for double balloon group, and no significant difference was found between two groups. Conclusions PKP is effective and relatively safe for OVCFs with either single or double balloons.
出处
《中华老年多器官疾病杂志》
2012年第10期761-764,共4页
Chinese Journal of Multiple Organ Diseases in the Elderly
