摘要
目的：探讨经皮球囊扩张椎体后凸成形术（ PKP）治疗老年多节段骨质疏松性椎体压缩性骨折（ OVCF）的疗效。方法：回顾性分析2010年12月～2013年8月应用PKP治疗的OVCF患者32例（102个椎体）的临床资料，男5例，女27例，年龄62～83岁，平均72．6岁，其中新鲜骨折74个椎体，陈旧性骨折28个椎体。2个节段者6例，3个节段者21例，4个节段以上者5例。术前均行胸腰椎X线正侧位片、CT及 MRI扫描检查。本组采取双侧穿刺者83个椎体，采用单侧穿刺者19个椎体。患者手术前后进行疼痛视觉评分（VAS），Cobb角及椎体矢状面指数（ SI）测量。应用SPSS13．0统计软件进行分析。结果：本组患者手术顺利，术中无脊髓及神经损伤等并发症发生，患者术后即感腰背疼痛明显缓解或消失，术后24～48小时支具保护下下床活动。患者手术前后VAS评分、SI指数及Cobb角对比显示有显著性差异（P＜0．01）。本组患者随访时间为4～36个月，平均24个月。5例患者随访期间症状复发，复查X线片示Cobb角略丢失，已行 PKP手术节段SI指数无改变，MRI显示有新发骨折，其中3例行保守治疗后缓解，2例再次行PKP手术，术后症状消失。结论：经皮球囊扩张椎体后凸成形术，能确切解除患者疼痛，在一定程度上恢复椎体形态及高度，是老年多节段骨质疏松性椎体压缩性骨折的安全有效治疗方法。
Objective：To discuss the effect of percutaneous kyphoplasty （ PKP） used in the treatment of osteoporotic multiple vertebral compression fractures in elderly patients .Method s：From 2010 December to 2013 August, retrospective analysis of 32 patients with OVCF who were treated by PKP （102 vertebraes ）clinical datas were carried out , male 5 cases,female 27 cases, age range 62-83 years, aver-age 72.6 years old, including 74 fresh fracture vertebras, 28 old fracture vertebras.6 cases of 2 vertebras,21 cases of 3vertebras , 5 cases of 4 vertebras above .All the patients underwent lumbar and thoracic spine anteroposterior and lateral X -ray, CT and MRI scanning be-fore surgery.The group take bilateral puncture 83 vertebras, take unilateral puncture 19 vertebras.ALL patients were carried out with a visual analog pain scores （ VAS） , vertebral kyphosis angle （Cobb angle ） , vertebral sagittal index （ SI）measurements before and after sur -gery.We use SPSS13.0 statistical software to analysis .Results：The group surgery was smoothly, without the occurrence of spinal cord and nerve injury and other complications of surgery , patients feel the waist and back pain significant relief or relieved after surgery , and get ambulation under the protection of orthosis .From 24 to 48h after surgery, compared with the preoperative VAS score , SI index and Cobb angle showed significant difference （P〈0.01）.The patients were followed up for 4-36 months, average 24 months.5 cases of patients symptom recurrenced during follow -up, Review X-ray showed the Cobb angle had slightly lost , SI index of vertebras with PKP did not change, MRI showed a new fracture , 3 patients of them symptoms relieved after conservative treatment , 2 patients of them take up surgery again, symptoms disappeared after surgery .Conclusion：Percutaneous kyphoplasty can relieve the pain exactly , restore vertebral shape and height in a certain extent .So, percutaneous kyphoplastyis a effective and safe method for the treatment of osteop
出处
《中国伤残医学》
2014年第9期1-4,共4页
Chinese Journal of Trauma and Disability Medicine
关键词
老年
骨质疏松
脊柱骨折
椎体成形术
Gerontism
Osteoporosis
Spinal column fracture
Vertebroplasty
