【摘要】 [目的]总结经皮后凸成形术在治疗骨质疏松性椎体压缩骨折中的经验和体会。[方法]回顾性分析应用经皮后凸成形术治疗的胸腰椎压缩骨折患者31例46椎,男9例,女22例,年龄61～78岁,平均68岁,椎体骨折位于T7～L3,术前对31例患者均拍摄X线片、CT及MRI,手术采用局部浸润麻醉,经双侧入路球囊扩张注射PMMA骨水泥20例,单侧注射11例,手术前后进行VAS评分、椎体矢状面指数及前后凸Cobb′s角测量,进行配对t检验统计分析。[结果]所有患者随访6～30个月,平均18个月,VAS评分由术前平均8.7分降为术后2.5分(P<0.001),终末随访为2.8分,椎体矢状面指数(SI)由术前平均54%恢复至术后88%(P<0.001),终末随访为83%,Cobb′s角由术前平均23°恢复为4.8°(P<0.001),终末随访为5.5°,术后93%的患者疼痛明显减轻或消失,无感染及胸肋部刺激性疼痛,无循环及呼吸系统并发症,4例术中发生少量骨水泥渗漏至椎体旁,经术中及术后长期观察,未造成任何神经及血管并发症。[结论]经皮后凸成形术在治疗胸腰椎骨质疏松性骨折中有确切缓解疼痛及恢复椎体高度和形态的作用,是一种理想的治疗方法。更多还原

【Abstract】 [Objective]To evaluate the efficacy of percutaneous kyphoplasty (PKP) in managing vertebral compression fractures due to osteoporosis(OVCF).[Method]Thirty-one OVCFs patients (46 vertebrae) undergoing PKP were retrospectively analyzed.In these patients,there were 9 males and 22 females who were from 61 to 78 years old with averaged 68 years,and the injured vertebrae were from T7 to L3.All the patients had plain X-rays and CT scan as well as MR images preoperatively.With all of the patients,local infiltration anesthesia were performed,20 were injected bilaterally while 11 unilaterally.Before and after operarion,the visual analogue scale (VAS) score was estimated and sagittal index(SI) as well as Cobb′s angle of the vertebrae were measured.The data were statistically analyzed with the method of paired t-test.[Result]The duration of follow up after operetion were 6 to 30 months with a mean of 18 months.The VAS score reduced from 8.7 before operation to 2.5 after operation (P<0.001)and sagittel index(SI)increased from 54% to 88%(P<0.001)while Cobb′s angle decreased from 23°to 4.8°(P<0.001).The back pain in 93 % out of all patients completely disappeared or relieved obviously postoperatively.The complications such as infections,pain in stemocostal part,circulatory and respiratary disorders did not occure except the leakage of PMMA in 4 patients which did not cause any nervous and vascular complications either during the operation or in a long period after operation.[Conclusion]PKP has exact efficacy on reducing back pain and restore the height and shape of vertebrae and is a ideal method in the treatment of vertebral compression fractures due to osteoporosis.更多还原