【摘要】 目的探讨经皮椎体后凸成形术(PKP)治疗骨质疏松性多节段椎体压缩性骨折的疗效和安全性。方法采用Sky膨胀式椎体成形器或球囊扩张对骨质疏松性椎体压缩性骨折65例238椎(其中Sky组20例,球囊组45例)行经皮椎体后凸成形术治疗。在X线片上测量术前、术后的椎体前缘、中线、后缘的高度及术后后凸畸形纠正范围。术前的临床所见及随访结果均采用Oswestry功能障碍指数和疼痛视觉模糊评分进行评定。结果65例术后24 h内疼痛症状明显缓解或消失。后凸畸形纠正范围11～26°,平均17°。随访9～46个月,平均24.8个月,患者诉明显疼痛,X线片示椎体高度未见明显丢失,未出现严重并发症。术后3个月及最后随访时Oswestry功能障碍指数和VAS评分均较术前有明显改善(P<0.05)。Sky组与球囊组疗效比较无显著性差异(P>0.05)。结论Sky膨胀式椎体成形器及球囊扩张PKP治疗多发性骨质疏松性椎体压缩性骨折,均能迅速缓解疼痛,恢复椎体高度,但球囊对于一次治疗多椎体病变更为经济、适用。更多还原

【Abstract】 Objective To explore the efficacy and safety of PKP in treatment of multiple osteoporotic vertebral compression fractures.Methods Twenty case Sky expansion PKP and 45 case balloon PKP procedures were performed.Patients were evaluated with Visual Analogue Scale(VAS) and Oswestry Disability Index(ODI).The anterior height,midline height,posterior height of the vertebrae body and kyphotic angle were measured preoperatively and postoperatively.Results Sixty-five cases of postoperative pain were evidently relieved or disappeared within 24 hours.The kyphotic angle was decreased 11～26°(mean 17°).Sixty-five cases were followed up for 9～46 month,with an average of 24.8 months.There were neither obvious pain,nor serious complications.X-ray showed no obvious loss of vertebral height.The postoperative ODI and VAS were obviously improved than preoperative(P<0.05).The efficacy comparison between Sky group and balloon group was no significant difference(P>0.05).Conclusion Sky expansion PKP and balloon PKP in treatment of osteoporotic vertebral compression fractures can quickly relieve pain and restore vertebral height,while balloon PKP is much more economical and especially suitable for multiple level compressive fractures.更多还原