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经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折疼痛:初步报告。

Modification of percutaneous vertebroplasty for painful old osteoporotic vertebral compression fracture in the elderly: preliminary report.

机构信息

Department of Spinal Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan Shandong, China.

出版信息

Injury. 2012 Apr;43(4):486-9. doi: 10.1016/j.injury.2011.12.021. Epub 2012 Jan 9.

Abstract

OBJECTIVE

To study the clinical efficacy of modified percutaneous vertebroplasty (PVP) in the treatment of painful old osteoporosis vertebral compression fractures (OVCF).

METHODS

From April 2007 to October 2009, 16 cases (23 vertebrae) of symptomic old OVCF were treated with a modified PVP. Before operation, all the patients were examined by standing anteroposterior and lateral X-Ray and MRI. The pain level of each patient was assessed before operation and 1 week, 6, 12 months after the operation using visual analogue scale (VAS) and Oswestry disability index (ODI). The middle line vertebral body height and local sagittal Cobb's angle were also measured.

RESULTS

Postoperative average VAS, Oswestry disability index (ODI), the local sagittal Cobb's angle decreased from 7.8, 72.3%, and 38.2° to 3.1, 26.8%, and 21.5° respectively before and after surgery (p<0.05). The mean midline vertebral height increased from 13.8mm to 26.6mm before and after surgery (p<0.05). There was no infection, nerve injury, pulmonary embolism, or death after operation.

CONCLUSIONS

The modified PVP can increase the space for bone cement filling and is good for the restoration of vertebral body height. It is an optimal procedure for the treatment of painful old OVCF.

摘要

目的

研究改良经皮椎体后凸成形术(PVP)治疗疼痛性陈旧性骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。

方法

2007 年 4 月至 2009 年 10 月,对 16 例(23 个椎体)有症状的陈旧性 OVCF 患者采用改良 PVP 治疗。术前所有患者均行站立位前后位和侧位 X 线和 MRI 检查。采用视觉模拟评分(VAS)和 Oswestry 功能障碍指数(ODI)评估每位患者术前及术后 1 周、6 个月和 12 个月的疼痛程度。还测量了椎体的中线高度和局部矢状 Cobb 角。

结果

术后平均 VAS、ODI、局部矢状 Cobb 角分别从 7.8、72.3%和 38.2°下降到 3.1、26.8%和 21.5°(p<0.05)。术后中线椎体高度从 13.8mm 增加到 26.6mm(p<0.05)。术后无感染、神经损伤、肺栓塞或死亡。

结论

改良 PVP 可增加骨水泥填充空间,有利于恢复椎体高度,是治疗疼痛性陈旧性 OVCF 的最佳方法。

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