经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折.doc

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1、经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折【摘要】探讨经皮椎体成形术及后凸成形术治疗骨质疏松性脊柱压缩骨折的临床疗效及并发症。［方法］本组18例27椎，对14例23椎行经皮椎体成形术(percutaneousvertebroplasty,PVP)，4例4椎行经皮椎体后凸成形术(percutaneouskyphoplasty，PKP)，术前及术后3d进行疼痛视觉类比评分(visualanaloguescale,VAS)和活动能力评分；随访期间观察患者疼痛缓解及生活能力状况，并分析骨水泥渗漏、邻椎骨折等并发症。［结果］手术全部成功，术后早期疼痛明显缓解，VAS评分术

2、后3d(2.5±0.6)较术前(7.5±0.7)明显下降(P<0.01)；活动能力评分术后3d(1.2±0.4)较术前(2.4±0.6)明显改善(P<0.01)。经平均15.6个月随访，1例患者出院后因并发心脏病死亡；4例发生周围椎体骨折；3例发生骨水泥渗漏。患者对治疗效果满意。［结论］只要严格掌握手术适应证，术中精心操作，经皮椎体成形术及后凸成形术为老年骨质疏松性脊柱压缩骨折治疗的理想选择，但与手术相关的并发症要引起重视。【关键词】骨质疏松脊柱骨折经皮椎体成形术后凸成形术Abstract：［Objective］Tostudytheeffectandcompl

3、icationsofpercutaneousvertebroplastyandkyphoplastyintreatingosteoporoticspinalcompressionfractures．［Method］Eighteenpatientswithtwentysevenvertebrasingroup，PVP(percutaneousvertebroplasty)wereperformedinfourteenpatients(twentythreevertebras)，PKP(percutaneouskyphoplasty)wereperformedinfour

4、patients(fourvertebras)，VAS(Visualanaloguescale)andmobilitywereevaluated3daysbeforeandafteroperation．Reliefof　backpain、recoveryoflivingabilityandcomplicationswereobservedinthefollowup．［Result］Allpatientswereoperatedonsuccessfullyandtheirbackpainrelievedimmediatelyafteroperation，VASwasdis

5、tinctlydecreasedfrom(7.5±0.7)pre-operationto(2.5±0.6)at3dayafteroperationwithasignificantdifference(P<0.01)；Scaleofpatient，smobilitywasdistinctlydecreasedfrom(2.4±0.6)preoperationto(1.2±0.4)at3dayafteroperationwithasignificantdifference(P<0.01)．Duringaverage15.6monthsfollowup，onep

6、atientdiedbecauseofheartdiseaseaftertwomonths，neighborvertebralfractureoccurredinfourpatients，bonecementleakageinthreepatients．Allpatientsgotsatisfactoryclinicaleffect．［Conclusion］Understrictselectionandelaborateoperation,PVPandPKPareidealmethodsintreatingosteoporoticspinalcompressionfrac

7、tures，butthecomplicationsrelevanttooperationshoudbeconsidered．Keywords：osteoporosis；spinalfractures；percutaneous4vertebroplasty；kyphoplasty胸腰椎压缩性骨折是老年骨质疏松症患者常见并发症，影响老年人的生活与生存质量。保守治疗卧床时间长，易致严重并发症的发生，并对短期内疼痛缓解不佳；外科手术创伤大、并发症多及患者全身境况差而难以推广。本科于2004年9月～2006年9月应用经皮椎体成形术及后凸