經(jīng)皮椎體后凸成形術(shù)治療重度骨質(zhì)疏松椎體壓縮性骨折.pdf

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1、·1220·浙江臨床醫(yī)學(xué)2o14年8月第16卷第8期經(jīng)皮椎體后凸成形術(shù)治療重度骨質(zhì)疏松椎體壓縮性骨折張濤姜為民★王根林李雪峰汪恒【摘要】目的探討應(yīng)用經(jīng)皮球囊椎體后凸成形術(shù)(percutaneouskyphoplasty，PKP)治療重度骨質(zhì)疏松性椎體壓縮性骨折(osteoporoticvertebralcompressionfracture，OVCF)的可行性和有效性。方法對33例重度骨質(zhì)疏松性椎體壓縮性骨折患者行PKP術(shù)。測量傷椎前緣、中緣及Cobb’s角度術(shù)前、術(shù)后值，同時(shí)應(yīng)用視覺模擬數(shù)字評分(VAS)及功能障礙指數(shù)(OD

2、I)綜合評估手術(shù)療效。結(jié)果33例患者手術(shù)均順利，術(shù)后隨訪14～39個(gè)月，平均22．6個(gè)月。VAS評分、ODI評分分別由術(shù)前的(7．9±0．8)分、(74．2±9．9)分降至術(shù)后的(2．9±0．9)分、(36．8±8．6)分，差異有統(tǒng)計(jì)學(xué)意義(P

3、5)。術(shù)前椎體Cobb’s角度(25．3±8．8)。，術(shù)后(14．7±7．2)。，差異有統(tǒng)計(jì)學(xué)意義(P<0．05)。l1例(33％)術(shù)中出現(xiàn)骨水泥滲漏，但并未產(chǎn)生臨床癥狀。結(jié)論經(jīng)皮球囊椎體后凸成形術(shù)治療重度骨質(zhì)疏松椎體壓縮陛骨折療效確切，并發(fā)癥少，術(shù)后功能恢復(fù)良好。【關(guān)鍵詞】骨質(zhì)疏松癥椎體壓縮性骨折經(jīng)皮球囊椎體后凸成形術(shù)骨水泥漏【Abstract】ObjectiveToevaluatethefeasibilityandeficacyofpercutaneouskyphoplastyintreatingverysevereost

4、eoporoticvertebralcompressivefracture．MethodsBetweenJanuary2008andDecember2012，33patients(20women，13men)withveryseverevertebralfracturebodiesunderwentballoonkyphoplasty．Theanteriorvertebralheight，middleVertebralheight，localkyphoticangle。visualanaloguescale(VAS)，Oswe

5、stryDisabilityIndex(ODI)andtheincidenceofcementleakagewereusedtoevaluatepainstatusandfunctionalactivitybeforetheoperation，1dayaftertheoperationandatthefinalfollow-up．ResultsAll33patientstoleratedprocedurewel1．Themeanfollow—upwas22．6months(inrangefrom14to39months)．Th

6、eVASandODIdecreasedrespectivelyfrom7．9±0．8and74．2±9．9preoperativelyto2．9±0．9and36．8士8．6postoperatively(P<0：05)；theVASandOD1was2．7±1．1and35．6±6．9atthefinalfollow-upwhichhadnosignificantdiferencebetweenpostoperativeandfinalfollow—up(P>O．05)．Theanteriorandmiddleheighto

7、ffracturevertebralbodyimprovedfrom(30．6±8．1)％，(40．5±14．9)％preoperativelyto(66．9±13．5)％，(74．5±10．3)％postoperatively(P<0．05)．Therewasasignificantdifferencebetweenpreoperativeandpostoperativeheightoftheanteriorandmiddlevertebralbody．TheCobb’sangleimprovedfrom(25．3±8．8)

8、。preoperativelyto(14．7±7．2)。postoperatively(P<0．05)．Asymptomaticcementleakageoccurredin11patients(33％)inourstudy．ConclusionBalloonkyphopla