Yang Hui-lin, Gu Xiao-hui, Chen Liang, Lu Jian, Mao Hai-qing, Meng Bin, Niu Guo-qi, Zhao Liu-jun, Tang Tian-si
Department of Orthopaedics, the First Affiliated Hospital of Soochow University, Suzhou 215006, China.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2005 Apr;27(2):174-8.
To investigate the selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fracture.
Twenty-two consecutive procedures were performed in 17 aged patients with osteoporotic spinal compression fractures from April 2002 to June 2004. The signal changes in different sequences were confirmed by magnetic resonance imaging before the procedures. This operation involved the percutaneous insertion of two inflatable bone tamps into a fractured vertebral body transpedicularly under fluoroscopic guidance. Every patient was treated individually, according to the results of radiography and CT scan before operation. Preoperative and postoperative complications, visual analogue scale, and radiographic findings such as vertebral height and Cobb angle were recorded and analyzed.
All patients tolerated the procedure well with immediate relief of their back pain in 24 hours. There was no leakage of cement into the epidura. The mean loss percent of the anterior and middle vertebral heights were (35.32 +/- 13.15)% and (27.53 +/- 12.61)% before operation, and (14.21 +/- 12.43)% and (16.2 +/- 7.5)% after operation. The height restoration of vertebra was confirmed by X-ray after the procedure (P < 0.01). The mean kyphosis was improved from (25.3 +/- 4.2) degrees to (8.6 +/- 5.1) degrees. No complications occurred. No patient had nerve injury. The patients were allowed to walk next day after the procedure.
The selectivity and individualization of transpedicular balloon kyphoplasty for aged osteoporotic spinal fractures has satisfactory short-term clinical efficacy. It is also an effective way to prevent complications.
探讨经皮椎体后凸球囊成形术治疗老年骨质疏松性脊柱骨折的选择性和个体化。
2002年4月至2004年6月，对17例老年骨质疏松性脊柱压缩骨折患者连续实施了22例手术。术前通过磁共振成像确认不同序列的信号变化。该手术包括在透视引导下经皮经椎弓根向骨折椎体插入两个可膨胀骨填充器。根据术前X线和CT扫描结果对每位患者进行个体化治疗。记录并分析术前和术后并发症、视觉模拟评分以及椎体高度和Cobb角等影像学表现。
所有患者对手术耐受性良好，术后24小时背痛立即缓解。骨水泥无渗漏至硬膜外。术前椎体前、中高度平均丢失百分比分别为(35.32±13.15)%和(27.53±12.61)%，术后分别为(14.21±12.43)%和(16.2±7.5)%。术后X线证实椎体高度得到恢复(P<0.01)。平均后凸畸形从(25.3±4.2)度改善至(8.6±5.1)度。无并发症发生。无患者出现神经损伤。术后次日患者即可下地行走。
经皮椎体后凸球囊成形术治疗老年骨质疏松性脊柱骨折的选择性和个体化具有满意的短期临床疗效，也是预防并发症的有效方法。
