球囊扩张椎体成形术 [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疗效分析]

　　【摘要】目的分析球囊扩张椎体后凸成形术(PKP, percutaneons kyphoplasty)治疗老年骨质疏松脊柱压缩骨折(OVCF, osteoporosis vertebral compression fractures)的疗效和安全性。方法回顾本院行球囊扩张椎体后凸成形术的37例56椎老年骨质疏松脊柱压缩骨折患者，根据术前和预后的疼痛得分(VAS, visual analog scale)、椎体高度、Cobbs角大小及术后并发症评价临床疗效和安全性。结果患者术后VAS较术前显著降低(P<005)，椎体或腰背部疼痛明显缓解或消失；末次随访侧位X线片测得骨折椎体前、中部的高度恢复为原椎体高度的(7234±1936)%、(7621±2004)%，较术前(5526±1864)%、(5717±1913)%显著升高(P<005)，骨折复位良好；Cobb角较术前231°±47°显著降低(P<005)，骨折处脊柱后凸明显得到矫正；患者完成6～24个月随访，无感染、骨水泥渗漏、椎管狭窄加重、循环及呼吸系统障碍等严重并发症。结论球囊扩张椎体后凸成形术治疗老年骨质疏松性骨折可明显缓解疼痛、恢复椎体高度和形态，且无严重并发症，疗效显著，临床安全。
　　【关键词】球囊扩张；椎体后凸成形术；老年骨质疏松脊柱压缩骨折；疗效；安全性
　　Effect analyze of balloon dilation Percutaneous Kyphoplasty for aged Osteoporosis Vertebral Compression FracturesQIN Huaqing Department of orthopedics, The Peoples Hospital of Changle, Weifang, Shandong 262400，China
　　【Abstract】ObjectiveTo analyze the efficacy and safety of percutaneons kyphoplasty (PKP) in the treatment of aged osteoporosis vertebral compression fractures (OVCF) Methods37 cases of OVCF (56 vertebrae) received from 2008 to 2011 and inflicted balloon dilation PKP were retrospectively analyzed, and the efficacy and safety were estimated through preoperative and postoperative indicators including the visual analogue scale(VAS)score, and the anterior and midline vertebral heights for fractured vertebrae, as well as Cobb angle of the vertebrae. ResultsThe postoperative patients VAS score was significantly reduced than that of preoperation (P<005), and the pain of suffers was relieved or disappeared obviously The rate of postoperative anterior and midline vertebral heights for fractured vertebrae were(7234±1936)% and(7621±2004)%, which were significantly recovered than preoperation(P<005) The postoperative Cobb angle was (171±31), which was decreased significantly than preoperation(231°±47°)(P<005) All patients were followed up for 624 months and none serious complication such as infections, bone cement leakage, spinal canal narrowing, circulatory and respiratory disorders occurred ConclusionThe balloon dilation PKP is effective and safe to treat aged osteoporosis vertebral compression fractures which can obviously relieve the pain and recover the shape and function of fractured vertebrae.
　　【Key words】Balloon dilation；Percutaneons kyphoplasty; Aged osteoporosis vertebral compression fractures; Efficacy;Safety
　　作者单位：262400山东省昌乐县人民医院骨二科骨质疏松椎体压缩性骨折(OVCF)是老年人常见疾病，压缩性骨折导致脊柱进行性畸形和生物力学改变，可引发进一步骨折，传统疗法药物镇痛、开放性手术等，不能有效修复脊柱序列缺损、骨质疏松等问题，临床治疗难愈，严重影响患者生活质量。文献报道［1］，球囊扩张PKP通过球囊扩张和骨水泥灌注使塌陷椎体复位，能有效稳定骨折，迅速缓解疼痛，预防进行性脊柱塌陷，本院对收治的部分OVCF患者行球囊扩张PKP治疗，疗效显著，报告如下。