摘要
目的探讨球囊扩张椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折的疗效和安全性。方法自2000年5月～2002年6月采用椎体后凸成形术(kyphoplasty)治疗老年骨质疏松脊柱压缩骨折30例56椎,均为椎体后壁完整的疼痛性骨质疏松脊柱压缩骨折。手术过程包括经双侧椎弓根或椎弓根旁置入两枚可扩张球囊使骨折塌陷椎体复位,以及用骨水泥充填由球囊扩张所形成的椎体内空腔。观察术后症状改善及骨折复位情况,分析并发症。结果30例患者手术均顺利完成,在术后48h内疼痛均明显缓解。骨折椎体前缘和中部高度的丢失分别由术前的(13.6±2.3)mm和(9.2±1.4)mm减至术后的(4.7±1.5)mm和(3.4±1.1)mm,后凸畸形Cobb角由术前的23.4°±5.2°矫正至术后的9.2°±4.7°。1例患者术后发现少量骨水泥渗漏至椎体侧方软组织内;1例1侧术中穿刺管内出现脑脊液,当即停止该侧手术。此2例患者均未出现临床症状。未出现其他严重并发症。结论球囊扩张椎体后凸成形术作为治疗疼痛性骨质疏松脊柱压缩骨折的新型微创技术,能迅速缓解疼痛、改善功能并恢复脊柱序列。
Objective To evaluate the efficacy and safety of balloon kyphoplasty in the treatment of painful osteoporotic vertebral compressive fractures. Methods From May 2000 to June 2002, 56 consecutive procedures were performed in 30 patients of painful osteoporotic vertebral compressive fractures with intact posterior vertebral body wall. Each procedure includes bilateral insertion of inflatable balloon, fracture reduction and fulfilled with bone cement. Preoperative and postoperative symptom levels, complications and radiographic findings were recorded and analyzed. Results All 30 patients tolerated the procedure well with immediate relief of their back pain in 48 hours. The mean loss of the anterior and mid vertebral body heights were (13.6±2.3) mm, (9.2±1.4) mm preoperatively and (4.7±1.5) mm, (3.4±1.1) mm postoperatively. The mean kyphosis was improved from 23.4°±5.2° to 9.2°±4.7°. Cement leakage and cerebrospinal fluid leakage occurred at one level respectively and resulted in no clinical symptoms, no other complication was found. Conclusion As a promising minimally invasive surgery, balloon kyphoplasty can provide early improvement of pain and function as well as spinal alignment in treatment of painful osteoporotic compressive fractures.
出处
《中华骨科杂志》
CAS
CSCD
北大核心
2003年第5期262-265,共4页
Chinese Journal of Orthopaedics
