摘要
目的探讨单侧椎弓根入路行椎体成形术治疗骨质疏松性严重压缩性骨折的可行性及疗效。方法回顾性分析完成椎体成形术88例患者,包括167节骨质疏松性压缩骨折的椎体。20例患者25节椎体为严重压缩骨折。严重压缩骨折定义为骨折椎体高度小于原来椎体高度的1/3。术前及术后进行视觉模拟疼痛评分及Oswesty功能障碍指数,并观察其并发症等情况。结果20例患者25节严重压缩骨折椎体采用单侧入路的椎体成形术治疗均获成功,术中注射骨水泥量平均为(4.4±0.9)ml。术后1d疼痛缓解及功能恢复显著(P<0.05)。7节椎体发生骨水泥椎间盘外漏,16节椎旁静脉丛外漏,10节椎体周围软组织外漏,1节椎体硬膜外漏,上述病例均未出现临床症状。结论单侧椎弓根入路的椎体成形术是治疗骨质疏松性严重压缩性骨折的可行及有效方法。
Objective To determine the feasibility and efficacy of percutaneous vertebroplasties in treating severe vertebral body compression fractures in patients with osteoporosis via an unipedicular approach. Methods In 88 patients, 167 percutaneous vertebroplaties were performed because of osteoporotic compression fractures. Of these, 20 patients（ 13 women, 7 men; mean age 72 ± 7.7 years）underwent 25 vertebroplasties for severe osteoporotic vertebral body compression fracture. The severe fracture compression was defined as the vertebral body been collapsed to less than one-third of the original height. Imaging and clinical features were analyzed, including the extent of vertebral collapse, location of the involved vertebra, volume of polymethylmethacrylate injected, vertebroplasty complication, and clinical outcome. The VAS and ODI of preand post-operation were recorded and analyzed with Paired-Samples T Test. Results The procedures were successful in all the involved patients and no significant complications were noted clinically. The cement leakage observed on radiographs included slight leakage into the adjacent disc （7 of 25, 28% ）, perivertebral venous plexus （16 of 25, 64% ）, paravertebral soft tissues（ 10 of 25, 40%）and epidura of vertebral canal （I of 25, 4% ）, but without any clinical symptoms. Pain relief and activity improvement were remarkable at I day follow-up after PVP （P 〈 0.05）. Conclusions Percutaneous vertebroplasty for severe osteoporotic vertebral body compression fractures via an unipedicular approach is safe and effective and should not be withheld in this kind of patients, though the radiographic complications were relatively high.
出处
《介入放射学杂志》
CSCD
2008年第2期114-117,共4页
Journal of Interventional Radiology
关键词
椎体成形术
骨质疏松性严重椎体压缩性骨折
单侧椎弓根入路
Percutaneous vertebroplasty
Severe osteoporotic vertebral body compression fractures
Unipedicular approach
