经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩骨折被引量：68

Clinical efficacy of percutaneous kyphoplasty in management of osteoporotic thoracolumbar vertebral compression fracture in the elderly

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摘要目的探讨经皮椎体后凸成形术（PKP）治疗老年骨质疏松性椎体压缩骨折的临床疗效. 方法 2007年3月-2013年2月采用PKP治疗椎体骨质疏松性压缩骨折210例,其中男100例,女110例;年龄55 ～91岁,平均72.5岁.其中单椎骨折180例,双椎体骨折20例,3椎体骨折10例,共250个椎体,分布范围T6～ L5.每个椎体注入骨水泥3～5 ml,平均4 ml.检测术前术后椎体高度、Cobb角和视觉模拟评分（VAS）,评价治疗效果. 结果术后随访6～15个月,平均11个月,患者胸腰背部疼痛均明显缓解或消失.术前患者VAS（8.7±1.2）分,椎体前缘高度丢失（11.0±3.2）mm,椎体中部高度丢失（8.6 ±1.1）mm,Cobb角（29.8±4.5）°;术后分别为（2.6±0.7）分、（5.5 ±0.8）mm、（3.3±1.0） mm、（16.7±3.4）°（P＜0.01）.4例骨水泥椎间隙渗漏未出现疼痛不适;2例骨水泥椎管内渗漏出现下肢神经刺激症状,对症治疗后恢复. 结论 PKP可重建骨折椎体高度,增加椎体刚度和稳定性,有效缓解胸腰背部疼痛,是治疗老年骨质疏松性椎体压缩骨折的有效方法. Objective To evaluate the clinical efficacy of percutaneous kyphoplasty （PKP） in surgical treatment of osteoporotic thoracolumbar vertebral compression fracture in the elderly.Methods From March 2007 to February 2013,210 cases （100 males and 110 females;55-91 years of age,mean 72.5 years） of osteoporotic vertebral compression fracture were treated with PKP.Single-segment fracture was observed in 180 cases,two-segment fracture in 20 cases and three-segment fracture in 10 cases.Lesion involved in 250 vertebrae located in the T6-L5 segment.Bone cement injected into each vertebra was 3-5 ml （mean,4 ml）.Treatment effects were assessed with vertebral height,Cobb angle and visual analogue score （VAS）.Results At the follow-up of 6-15 months （mean 11 months）,thoracic back pain significantly alleviated or disappeared.After operation,improvements were observed in VAS [（8.7 ± 1.2） points vs （2.6 ±0.7） points],anterior vertebral height loss [（11.0 ±3.2） mm vs（5.5 ± 0.8） mm],central vertebral height loss [（8.6 ± 1.1）mm vs （3.3 ± 1.0） mm],and Cobb angle [（29.8 ± 4.5） ° vs （16.7 ± 3.4） °] （P 〈 0.01）.Four patients appeared no pain or numbness in lower limbs although cement leak into disc.Whereas two patients had lower extremity nerve irritation because of cement leak into the spinal canal and recovered after symptomatic treatment.Conclusion PKP is an effective method for treatment of osteoporotic vertebral compression fracture in the elderly,for it can rebuild vertebral height,increase vertebral rigidity as well as stability and relieve thoracic back pain.

作者刘纪恩曹珺勾瑞恩母心灵冯伟连鸿凯

机构地区郑州市第一人民医院脊柱外科

出处《中华创伤杂志》 CAS CSCD 北大核心 2015年第5期423-426,共4页 Chinese Journal of Trauma

关键词脊柱骨折骨质疏松经皮椎体后凸成形术 Spinal fractures Osteoporosis Percutaneous kyphoplasty

分类号 R687.3 [医药卫生—骨科学]

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