《中国康复理论与实践》

《中国康复理论与实践》

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经皮椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的效果①

王晓庆，吴学元，靳占奎，常彦海   

  1. 陕西省人民医院骨科，陕西西安市710068。
  • 出版日期:2016-08-25 发布日期:2016-09-22

Effects of Percutaneous Kyphoplasty on Osteoporosis Vertebral Compression Fractures in Elderly

WANG Xiao-qing, WU Xue-yuan, JIN Zhan-kui, CHANG Yan-hai   

  1. Department of Orthopedics, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi 710068, China
  • Published:2016-08-25 Online:2016-09-22

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摘要： 目的观察经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的效果及安全性。方法回顾性分析2014 年1 月~2015 年5 月88 例行PKP的老年OVCF患者，术前、术后1 周及末次随访时采用疼痛视觉模拟评分(VAS)及Oswestry 功能障碍指数(ODI)评价患者疼痛及生活质量；对比手术前后病椎后凸畸形角度(Cobb 角)和骨折椎体高度。观察骨水泥向椎体外渗漏情况及对神经功能的影响。结果出现骨水泥渗漏11 例，其中椎弓根内2 例，椎前静脉丛3 例，椎间隙渗漏3 例，椎体后缘渗漏3例；有神经压迫症状1 例，予行椎体后缘减压。患者术后1 周和末次随访时VAS 评分、ODI 评分和Cobb 角均显著低于术前(t>29.518, P<0.001)，椎体平均高度显著高于术前(t>35.173, P<0.001)。结论PKP治疗老年OVCF安全、有效，能够即刻并长期减少疼痛，纠正椎体后凸畸形，提高患者生活质量。

关键词: 椎体压缩骨折, 骨质疏松, 经皮椎体后凸成形术, 骨水泥, 并发症

Abstract: Objective To observe the clinical effect and safety of percutaneous kyphoplasty (PKP) on osteoporosis vertebral compression fractures (OVCF) in elderly. Methods From January, 2014 to May, 2015, 88 patients with OVCF treated with PKP were retrospective studied. Visual Analogue Scale (VAS) and Oswestry Dysfunction Index (ODI) were used to evaluate the pain and quality of life, and the kyphotic angle (Cobb's angle) and anterior vertebral body height were recorded before operation, one week after operation and the last follow- up. The cement leakage and its effect on nerve function were recorded. Results Bone cement leakage was found in eleven patients, in which two in pedicle, three in venous leakage, three in intervertebral disc and three in vertebral posterior. Nerve root symptoms appeared in one patient, who was treated with decompression. The scores of VAS and ODI, and the Cobb's angel were significantly lower (t>29.518, P< 0.001), and the vertebral body height was significantly higher (t>35.173, P<0.001) one week after operation and the last follow-up than before operation. Conclusion PKP is safe and effective for OVCF in elderly. It can efficiently reduce the pain, correct kyphotic deformity and improve the quality of life.

Key words: vertebral compression fracture, osteoporosis, percutaneous kyphoplasty, bone cement, complication