Liu Li-Chun, Ding Wen-Jun, Li Shi-Jun, Li Feng-Ji
Department of Orthopaedics and Traumatology, Orthopaedics Hospital of Xinqiao, Fenghua 315500, Zhejiang, China.
Zhongguo Gu Shang. 2010 Jun;23(6):448-50.
To study the clinical effects of percutaneous vertebroplasty and kyphoplasty in the treatment of fresh thoracolumbar fractures in the elderly.
From May 2004 to March 2009, among 29 patients (32 vertebras) with thoracolumbar fractures, 18 patients (21 vertebras) were treated with percutaneous vertebroplasty (PVP) and 11 patients (11 vertebras) were treated with percutaneous kyphoplasty (PKP). The visual analogue scale (VAS) and mobility were evaluated 3 days before and after operation. During follow-up period, patients were observed and evaluated in terms of relief of back pain and regaining of living ability. Complications such as bone cement leakage were analyzed.
All the patients got successful operation. The average operation time was 38.6 minutes for the 18 patients (21 vertebras) with PVP performed, and 3.2 ml (2-5 ml) bone cement was injected. For the 11 patients (11 vertebras) with PKP performed, the average operation time was 43 minutes, and an average of 3.8 ml (2-6 ml) bone cement was injected. The VAS decreased from preoperative (7.5 +/- 0.7) to (2.2 +/- 0.5) at the 3rd day after operation; the mobility scores of the patients decreased from preoperative (2.4 +/- 0.6) to (1.2 +/- 0.3) at the 3rd day after operation; the vertebral height increased from an average of (52.4 +/- 9.7)% pre-operation to (85.2 +/- 10.6)% after operation; and the average kyphosis correction of Cobb angle was 11.2 degrees. During an average of 12.6 months follow-up, no patients reported vertebral pain. Review of X-ray films showed no significant loss of vertebral height. One patient died from complications of heart disease 5 months being discharged from hospital. Another patient died from the same cause at 6 months after opertaion. Paravertebral leakage of bone cement was also found in 2 patients. No serious complications occurred and patients were satisfied with the treatment.
PVP, PKP can be used to instantly reinforce vertebral injury, relieve pain, and improve the patient's mobility. For elder people with fresh thoracolumbar fractures, when health conditions are allowed, PVP or PKP surgery is the right treatment.
探讨经皮椎体成形术（PVP）和经皮椎体后凸成形术（PKP）治疗老年新鲜胸腰椎骨折的临床效果。
2004年5月至2009年3月，29例胸腰椎骨折患者（32个椎体）中，18例患者（21个椎体）接受经皮椎体成形术（PVP）治疗，11例患者（11个椎体）接受经皮椎体后凸成形术（PKP）治疗。分别于术前、术后3天评估视觉模拟评分（VAS）及活动度。随访期间，观察并评估患者背痛缓解及生活能力恢复情况。分析骨水泥渗漏等并发症。
所有患者手术均成功。18例接受PVP治疗的患者（21个椎体）平均手术时间为38.6分钟，注入骨水泥3.2 ml（2 - 5 ml）。11例接受PKP治疗的患者（11个椎体）平均手术时间为43分钟，平均注入骨水泥3.8 ml（2 - 6 ml）。术后第3天VAS评分由术前（7.5±0.7）降至（2.2±0.5）；患者活动度评分由术前（2.4±0.6）降至术后第3天的（1.2±0.3）；椎体高度由术前平均（52.4±9.7）%增加至术后的（85.2±10.6）%；Cobb角平均后凸矫正11.2度。平均随访12.6个月，无患者诉椎体疼痛。X线片复查显示椎体高度无明显丢失。1例患者出院后5个月死于心脏病并发症。另1例患者术后6个月死于相同原因。2例患者出现椎旁骨水泥渗漏。未发生严重并发症，患者对治疗满意。
PVP、PKP可即时强化椎体损伤、缓解疼痛、改善患者活动度。对于老年新鲜胸腰椎骨折患者，在身体状况允许时，PVP或PKP手术是合适的治疗方法。
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