叶宏 陈小杰

[摘要] 目的：探讨球囊扩张椎体后凸成形注入骨水泥治疗老年骨质疏松性椎体压缩性骨折的临床效果。方法：选择我院2006年10月~2010年5月收治的应用经皮球囊扩张椎体后凸成形术治疗骨质疏松性椎体压缩性骨折的30例患者，按照VAS评分、影像学资料、Oswestry评分标准分别对患者疼痛、椎体高度和Cobb角、日常活动功能进行观察。结果：所有手术均顺利完成，无严重手术并发症。有7个椎体发生骨水泥渗漏，均未出现临床症状。术后患者腰痛均明显缓解，随访7~26个月，平均14个月，视觉模拟评分（VAS）由术前的（7.4±1.7）分下降至术后的（1.8±1.1）分，最终随访为（1.6±0.8）分；Oswestry功能评分术前为（40.00±1.16）分，术后为（17.00±2.11）分，末次随访为（15.00±1.41）分；椎体前缘的高度术前平均为（0.8±0.1）cm，术后为（1.2±0.3）cm，末次随访为（1.2±0.3）cm；伤椎后凸角度术前平均为（28.2±5.3）°，术后为（19.2±4.8）°,末次随访为（19.4±5.1）°。各指标术后与术前、最终随访时与术前差异均有统计学意义（P＜0.05）；术后与最终随访时差异无统计学意义（P＞0.05）。结论：球囊扩张经皮椎体后凸成形术是治疗老年骨质疏松性椎体压缩性骨折的有效方法，可迅速缓解疼痛，改善脊柱功能，并且远期稳定性较好，适用于年龄较大、合并症较多的老年患者。

[关键词] 球囊扩张椎体后凸成形术；骨水泥；骨质疏松；脊柱压缩性骨折

[中图分类号] R683.2 [文献标识码]B[文章编号]1673-7210（2011）11（c）-049-03

PKP and bone cement injected treatment for osteoporotic vertebral compression fractures in old patients

YE Hong, CHEN Xiaojie

Department of the 1st Orthopedic, Nanping First Hospital Affiliated to Fujian Medical University, Fujian Province, Nanping 350005, China

[Abstract] Objective: To investigate the effect of percutaneous balloon kyphoplasty treatment (PKP) and bone cement injected treatment for osteoporotic vertebral compression fractures (OVCF) in old patients. Methods: The data of 30 cases of OVCF treated by PKP and bone cement injection in our hospital from October 2006 to May 2010 were analyzed, according to VAS scores, imaging data, oswestry scoring criteria for patients, pain, vertebral height and Cobb angle, activities of daily living functions were observed. Results: All operations were successfully completed, no serious complications. There were seven vertebrae bone cement leakage, all were not appear clinical symptoms. Patients with low back pain were relieved after surgery, follow up for 7 to 26 months, average of 14 months, visual analogue scale (VAS) from preoperative (7.4±1.7) scores down to postoperative (1.8±1.1) scores, the final follow up was (1.6±0.8) scores; oswestry functional scores before surgery was (40.00±1.16) scores and after operation was (17.00±2.11) scores, the last follow up was (15.00±1.41) scores; preoperative anterior vertebral height average was (0.8±0.1) cm, postoperative was (1.2±0.3) cm, the last follow up was (1.2±0.3) cm; preoperative vertebral kyphosis averaged was (28.2±5.3)°, after operation was (19.2±4.8)°, final follow up was (19.4±5.1)°. The postoperative and preoperative indicators, and the final follow up and preoperative indicators had significant differences (P＜0.05); postoperative and final follow up indicators was no significant difference (P＞0.05). Conclusion: PKP is an effective method in treatment of OVCF, it can quickly relieve pain and improve spinal function, and long-term stability is better, apply to elderly patients with more complications.

[Key words] Percutaneous balloon kyphoplasty; Bone cement; Osteoporosis; Spinal compression fractures

老年骨质疏松患者骨质硬度较差，受曲力、压力、联合外力容易发生骨质疏松性椎体压缩性骨折，尤其是伴有椎体后壁破损者，稳定性差，保守治疗效果差，常需要椎体减压和固定。但是该类患者多年龄较大、体质弱、合并症多，对传统的切开减压内固定的耐受度较差，且术后并发症较多[1-2]。……