经皮椎体后凸成形术治疗重度骨质疏松椎体压缩性骨折.pdf

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1、·1220·浙江临床医学2o14年8月第16卷第8期经皮椎体后凸成形术治疗重度骨质疏松椎体压缩性骨折张涛姜为民★王根林李雪峰汪恒【摘要】目的探讨应用经皮球囊椎体后凸成形术(percutaneouskyphoplasty，PKP)治疗重度骨质疏松性椎体压缩性骨折(osteoporoticvertebralcompressionfracture，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(OD

2、I)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

3、5)。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)。l1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陛骨折疗效确切，并发症少，术后功能恢复良好。【关键词】骨质疏松症椎体压缩性骨折经皮球囊椎体后凸成形术骨水泥漏【Abstract】ObjectiveToevaluatethefeasibilityandeficacyofpercutaneouskyphoplastyintreatingverysevereost

4、eoporoticvertebralcompressivefracture．MethodsBetweenJanuary2008andDecember2012，33patients(20women，13men)withveryseverevertebralfracturebodiesunderwentballoonkyphoplasty．Theanteriorvertebralheight，middleVertebralheight，localkyphoticangle。visualanaloguescale(VAS)，Oswe

5、stryDisabilityIndex(ODI)andtheincidenceofcementleakagewereusedtoevaluatepainstatusandfunctionalactivitybeforetheoperation，1dayaftertheoperationandatthefinalfollow-up．ResultsAll33patientstoleratedprocedurewel1．Themeanfollow—upwas22．6months(inrangefrom14to39months)．Th

6、eVASandODIdecreasedrespectivelyfrom7．9±0．8and74．2±9．9preoperativelyto2．9±0．9and36．8士8．6postoperatively(P<0：05)；theVASandOD1was2．7±1．1and35．6±6．9atthefinalfollow-upwhichhadnosignificantdiferencebetweenpostoperativeandfinalfollow—up(P>O．05)．Theanteriorandmiddleheighto

7、ffracturevertebralbodyimprovedfrom(30．6±8．1)％，(40．5±14．9)％preoperativelyto(66．9±13．5)％，(74．5±10．3)％postoperatively(P<0．05)．Therewasasignificantdifferencebetweenpreoperativeandpostoperativeheightoftheanteriorandmiddlevertebralbody．TheCobb’sangleimprovedfrom(25．3±8．8)

8、。preoperativelyto(14．7±7．2)。postoperatively(P<0．05)．Asymptomaticcementleakageoccurredin11patients(33％)inourstudy．ConclusionBalloonkyphopla