摘要
目的评价经皮椎体后凸成形术（PKP）治疗伴裂隙征陈旧性椎体骨质疏松性骨折的疗效。方法2010年6月至2012年9月采用PKP治疗了25例（25个椎体）伴裂隙征的陈旧性椎体骨质疏松性骨折患者，男性8例，女性17例，年龄64～84岁，平均72．7岁，病程6周～24个月，平均7．8个月。手术前后采用疼痛视觉模拟评分（VAs）评估临床症状，摄站立位x线片测量病变椎体Cobb角及椎体前缘高度，并记录术中出血量、骨水泥量及并发症发生情况。结果25例患者均顺利完成手术，无严重手术并发症。术中透视见5个椎体（20％）出现骨水泥渗漏，其中渗漏至椎体前侧3例，椎体侧方2例。单个椎体手术时间35～60rain，平均42min；注射骨水泥量2．0～5．5ml，平均3．1ml；25例患者均获随访，随访时间6～15个月，平均12个月。患者术前、术后3d及末次随访时VAS评分分别为（7．44±1．0）分、（2．36土0．8）分、（2．12±0．7）分（F=297．84，P=0．000〈）；Cobb角分别为（28．28±3．76）°、（23．28±3．76）°、（24．32±3．94）°（F=12．39，P=0．000）；椎体前缘高度分别为（22．48±4．38）mm、（25．80±4．89）mm、（25．24±4．84）mm（F=3．56，P=0．034）；术后3d和末次随访时比较差异无统计学意义（均P）0．05）。结论PKP是治疗伴裂隙征的陈旧性骨质疏松性椎体压缩性骨折的有效方法，能快速缓解疼痛、矫正后凸畸形、预防椎体塌陷。
Objective To evaluate the effect of percutaneous kyphoplasty （PKP） in the treatment of old osteoporotic vertebral compression fractures with intravertebral clefts. Methods 25 patients （25 vertebrae） suffering from old OVCF with vacuum phenomenon were treated with PKP. There were 8 males and 17 females with an average age of 72. 7 years （range, 64-84 years） and with an average duration of 7.8 months （range, 6-24 months）. The height of anterior column and the posterior convex Cobb angle of injured spine were measured on the lateral X-ray film in standing position at pre-operation and post-operation. Clinical symptoms were evaluated by visual analogue scale （VAS）. The amount of bleeding and bone cement and complications were recorded. Results All of 25 operations were performed successfully without severe complications. Cement leakage occurred in 5 cases （20%）, including 3 cases at the anterior vertebral edge and 2 cases at the lateral vertebra. The surgery time for each vertebra was 35 - 60 min （mean 42 min）, and bone cement volume for each vertebra was 2.0±5.5 ml （mean 3.1 ml）. 25 patients were followed up for 12 months （range, 6-15 months）. The VAS score was decreased from （7.44±1.0） preoperatively to （2.36±0.8） day 3 postoperatively and to （2.12 ± 0.7） the last follow-up; the Cobbrs angle was improved from （28.28±3.76） to （23.28±3.76） and （24.32±3.94） respectively; and the anterior vertebral height was increased from （22.48±4.38） mm to （25.80±4.89） mm and （25.24±4.84） mm respectively. There were significant differences in VAS, Cobb＇s angle, and anterior vertebral height between pre- and post-operation （F=297.84, 12.39 and 3.56, P〈0. 001 or 0.05）, but there were no significant differences in these indicators between day 3 postoperatively and the last follow-up（all P）0.05）. Conclusions PKP is effective in the treatment of old osteoporotic vertebral compression fractures combined with ntravertebral clefts. It can relieve pain rapidly and effectively, correct kyphosis, and prevent vertebra collapse.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2014年第2期175-178,共4页
Chinese Journal of Geriatrics
关键词
椎体成形术
骨折
骨质疏松
Vertebroplasty
Fracture, bone
Osteoporosis
