Ge Jian-zhong, Zhang Hui-dong, Jin Wen-jian, Huangpu Jin-bian, Wang Mu-hua
The First People's Hospital of Yongquan, Shanxi, China.
Zhongguo Gu Shang. 2011 Oct;24(10):824-7.
To evaluate the therapeutic effect and security of CT guided unilateral percutaneous vertebroplasty (PVP) for the treatment of osteoporotic vertebral compression fracture (OVCF) in senile patients.
From April 2009 to June 2010, 26 patients undergoing CT guided unilateral percutaneous vertebroplasty were analyzed retrospectively. There were 9 males and 17 females,ranging in age from 60 to 85 years with an average of (67.50+/-6.76) years, ranging in course of disease from 2 to 30 days with an average of (8.92+/-4.36) d. The affected segments involved 35 vertebras. The major clinical manifestations of OVCF were lumbar-back pain (especially when turning over or stooping down) and unable to bear. The needle was punctured into vertebral of lesions through unilateral puncture under the CT guidance; and then 3-5 ml bone cement was injected into vertebral. Antibiotic was used 3 days to prevent postoperative infections. Postoperative complications were observed after operation, such as local leakage of bone cement, penetrating spinal cord and/or segmental spinal nerve injuries and pulmonary embolism. X-ray was used to measure the height of anterior, middle and exterior of vertebral before and after treatment. A visual analog scale (VAS) scoring was applied to evaluate pain score preoperative, 48 hours postoperative and the terminal follow-up.
Twenty-six patients achieved success in punctuation without serious complications. Local leakage of bone cement occurred in 6 cases, but without clinical symptoms or signs. One patient suffered from acute intraoperative reactions to bone cement and relieved by 5 mg dexamethasone and oxygen. All patients were followed up for 6 to 12 months [averaged (8.4+/-1.6) months]. The postoperative vertebrae height was higher than preoperative,but there was no statistical difference between postoperative and preoperative (P>0.05). Preoperative VAS scores was 7.63+/-0.92, postoperative score was 3.00+/-1.09, the final follow-up score was 2.38+/-1.17; there was significant difference between preoperative and postoperative at 48 hours (P<0.05), but there was no statistical difference between final follow-up and postoperative at 48 hours (P>0.05).
Unilateral PVP under CT guided can increase the vertebral strength and stabilize vertebral body,and the procedure is a safe and effective method for OVCF in elderly patients.
评估CT引导下单侧经皮椎体成形术（PVP）治疗老年骨质疏松性椎体压缩骨折（OVCF）的疗效及安全性。
回顾性分析2009年4月至2010年6月行CT引导下单侧经皮椎体成形术的26例患者。其中男性9例，女性17例，年龄60～85岁，平均（67.50±6.76）岁，病程2～30天，平均（8.92±4.36）天。累及椎体35个。OVCF主要临床表现为腰背痛（尤其是翻身或弯腰时）且无法耐受。在CT引导下经单侧穿刺将穿刺针穿入病变椎体；然后向椎体内注入3～5ml骨水泥。术后使用抗生素3天以预防感染。术后观察有无骨水泥局部渗漏、脊髓及/或节段性脊神经损伤、肺栓塞等并发症。治疗前后采用X线测量椎体前缘、中部及外侧高度。采用视觉模拟评分法（VAS）评估术前、术后48小时及末次随访时的疼痛评分。
26例患者穿刺均成功，无严重并发症。6例发生骨水泥局部渗漏，但无临床症状及体征。1例患者术中出现骨水泥急性反应，经5mg地塞米松及吸氧后缓解。所有患者随访6～12个月[平均（8.4±1.6）个月]。术后椎体高度高于术前，但差异无统计学意义（P>０.０５）。术前VAS评分为7.63±0.92，术后为3.00±1.09，末次随访时为2.38±1.17；术后48小时与术前比较差异有统计学意义（P<0.05），末次随访与术后48小时比较差异无统计学意义（P>0.05）。
CT引导下单侧PVP可增强椎体强度，稳定椎体，是治疗老年OVCF的一种安全有效的方法。
