摘要
目的探讨应用经皮球囊椎体后凸成形术（percutaneous kyphoplasty，PKP）治疗重度骨质疏松性椎体压缩性骨折（osteoporotic vertebral compression fracture，OVCF）的可行性和有效性。方法对33例重度骨质疏松性椎体压缩性骨折患者行PKP术。测量伤椎前缘、中缘及Cobb’s角度术前、术后值，同时应用视觉模拟数字评分（VAS）及功能障碍指数（ODI）综合评估手术疗效。结果33例患者手术均顺利，术后随访14～39个月，平均22．6个月。VAS评分、ODI评分分别由术前的（7．9±0．8）分、（74．2±9．9）分降至术后的（2．9±0．9）分、（36．8±8．6）分，差异有统计学意义（P〈O．05）；末次随访时VAS评分、ODI评分分别为（2．7±1．1）分、（35．6±6．9）分，较术后差异无统计学意义。伤椎前缘、中缘高度由术前的（30．6±8．1）％、（40．5±14．9）％恢复至术后的（66．9±13．5）％、（74．5±10．3）％，差异有统计学意义（P〈0．05）。术前椎体Cobb’s角度（25．3±8．8）°，术后（14．7±7．2）°，差异有统计学意义（P〈0．05）。11例（33％）术中出现骨水泥渗漏，但并未产生临床症状。结论经皮球囊椎体后凸成形术治疗重度骨质疏松椎体压缩性骨折疗效确切，并发症少，术后功能恢复良好。
Objective To evaluate the feasibility and efficacy of percutaneous kyphoplasty in treating very severe osteoporotic vertebral compressive fracture. Methods Between January 2008 and December 2012, 33 patients （ 20 women, 13 men ） with very severe vertebral fracture bodies underwent balloon kyphoplasty. The anterior vertebral height, middle Vertebral height, local kyphotic angle, visual analogue scale （ VAS ） , Oswestry Disability Index （ ODI ） and the incidence of cement leakage were used to evaluate pain status and functional activity before the operation, 1 day after the operation and at the final follow-up. Results All 33 patients tolerated procedure well. The mean follow- up was 22.6 months （ in range from 14 to 39 months ） . The VAS and ODI decreased respectively from 7.9 ± 0.8 and 74.2 ± 9.9 preoperatively to 2.9 ± 0.9 and 36.8± 8.6 postoperatively （ P〈0.05 ） ; the VAS and ODI was 2.7 ± 1.1 and 35.6 ± 6.9 at the final follow-up which had no significant difference between postoperative and final follow-up （ P〉0.05 ） . The anterior and middle height of fracture vertebral body improved from （ 30.6 ± 8.1 ） %, （ 40.5 ± 14.9 ） % preoperatively to （ 66.9 ± 13.5 ） %, （ 74.5±10.3 ） % postoperatively （P〈0.05） . There was a significant difference between preoperative and postoperative height of the anterior and middle vertebral body. The Cobb＇ s angle improved from （ 25.3 ±8.8 ）° preoperatively to （ 14.7 ±7.2 ）° postoperatively （P〈0.05） . Asymptomatic cement leakage occurred in 11 patients （33%） in our study. Conclusion Balloon kyphoplasty is a safe and effective procedure for treating severe osteoporotic vertebral compression fracture.
出处
《浙江临床医学》
2014年第8期1220-1223,共4页
Zhejiang Clinical Medical Journal
