摘要
目的探讨经皮椎体后凸成形术（PKP）治疗Genant Ⅳ级骨质疏松性椎体压缩性骨折（OVCF）的疗效和安全性。方法回顾性分析2012年8月-2015年6月行PKP治疗的GenantⅣ级OVCF26例35椎；其中男5例，女21例；年龄59～89岁，平均74．2岁。在C形臂X线机引导下，经皮穿刺进针，建立工作通道后放置球囊，扩张球囊复位骨折，形成空腔，退出球囊，向形成的空腔内注入骨水泥。观察术前、术后伤椎椎体前缘和中央的高度以及后凸角；采用视觉模拟评分（VAS）及Oswestry功能障碍指数（ODI）评估手术疗效；并分析并发症发生情况。结果26例患者均顺利完成手术。术后平均随访24．1个月。VAS和ODl分别由术前（8．2±1．1）分、（74．0±10．0）％降为术后的（2．9±1．6）分、（33．8±8．1）％（P〈0．01），椎体前缘、椎体中部的高度分别由术前（32．1±12．2）％、（39．1±12．2）％增至术后（57．1±12．4）％、（64．3±13．2）％（P〈0．01）。椎体后凸角由术前（22．3±9．6）。矫正至术后（16．5±9．3）。（P〈0．01）。随访过程中矫正度无丢失。6例8椎发生骨水泥渗漏，未出现临床症状。3例出现其他椎体骨折，1例手术椎（T11）及T12发生骨折。结论PKP可以治疗GenantⅣ级骨质疏松性椎体压缩性骨折，且安全有效。
Objective To evaluate the safety and efficacy of percutaneous kyphoplasty （PKP） in the treatment of Genant grade Ⅳ osteoporotic vertebral compression fracture （OVCF）. Methods Data of 26 patients （35 levels） undergone PKP due to Genant grade Ⅳ OVCF between August 2012 and June 2015 were retrospectively analyzed. The subjects included 5 males and 21 females, at mean age of 74.2 years （range, 59-89 years）. Specifically, transcutaneous needle puncture into the fracture vertebra was performed under C-arm X-ray monitoring, balloon was placed through the needle into the bone and inflated, and the cement was injected into the space once the balloon was removed. Symptom improvement, fracture reduction, kyphotic angle, and complications were recorded after operation. Results All 26 surgeries were uneventful. Mean period of follow-up was 24.1 months. Visual analogue score （VAS） decreased from preoperative （8.2 ±1.1 ） points to postoperative （2.9 ±1.6） points （P 〈0.01 ）. Oswestry disability index （ODI） decreased from preoperative （74.0±10.0） % to postoperative （ 33.8 ±8.1 ） % （ P 〈 0.01 ）. Anterior and middle vertebral body heights were （ 32.1 ± 12.2 ） % and （ 39.1 ±12.2）% before operation, and increased to （57.1 ±12.4）% and （64.3 ± 13.2）% after operation （ P 〈 0.01 ）. Kyphotic angle was （22.3±9.6）° before operation, and corrected to （ 16.5 ± 9.3 ）° after operation （P 〈 0.01 ）. No correction loss was noted at follow-up. Six patients with cement leakage in 8 levels were reported, but there were no clinical manifestations. Three patients developed additional fractures at untreated levels at follow-up, and one patient had fracture at the treatment level （i. e. T11 ） as well as at T12. Conclusion PKP is a safe and effective procedure in the treatment of Genant grade Ⅳ OVCF.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2015年第11期966-971,共6页
Chinese Journal of Trauma
基金
江苏省骨科临床医学研究中心建设资助项目（BL2012004）
