摘要
目的探讨经皮穿刺椎体成形术治疗老年性骨质疏松性椎体压缩骨折的临床疗效。方法 2006年1月2009年1月收治患者147例(214个椎体)脊柱骨折者,男56例,女91例;年龄61～80岁,平均69岁。脊柱骨折部位为T8～L3,其中胸椎98个,腰椎116个。采用C形X线机透视引导下于俯卧位或侧卧位进行经皮穿刺椎体成形术,注射聚甲基丙烯酸甲酯(PMMA,骨水泥)。测量并计算术前和术后椎体前/后缘高度比值,疗效评价按WHO标准。结果 118例获随访,随访时间3～7个月,平均4个月。147例214个椎体均手术成功,骨水泥注射量1.0～8.0mL/椎体。术后2～4h疼痛开始缓解,无显著危害性并发症发生,术前和术后椎体前/后缘高度比值无显著性差异,118例随访3～7个月疗效评价按WHO标准完全缓解加部分缓解率为100%。结论经皮穿刺椎体成形术是一种治疗老年性骨质疏松性椎体压缩骨折的微创手术,能够有效缓解骨质疏松性椎体骨折引起的疼痛,维持椎体稳定性,恢复椎体的高度,是一种简单、安全、有效的方法 。
Objective To observe the clinic outcome of the percutaneous vertebroplasty （PVP） in treatment of senile osteoporosis spinal compression fracture. Methods From January 2006 to January 2009,147 patients （91 females and 56 males） with 214 verteral compression fractures underwent PVP with an average of 69 years old ranged from 61 to 80. The fracture segments were within T8-L3 （98 thoracical vertebrae,116 lumbar vertebrae）. Under the guidance of C-arm fluorosecopy,bone marrow biopsy needle was inserted percutaneously via transpedicular way into the fractured vertebrae. Polymethylmethacrylate （PMMA） was then injected into the fractured vertebrae. The anterior and posterior edge of the vertebral body were measured and calculated the rate before and after PVP. The outcome was evaluated by WHO standard. Results A total of 118 cases were followed up for 3 to 7 months,and the average follow-up period was 4 months. PVP was successful in 147 cases （214 vertebrae）. The volume of PMMA injected was 1.0-8.0 mL per vertebrae. The low back pain was remarkable remitted 2 to 4 hours after operation,and there was no any notable complication encountered. Comparing to preoperation,the rate of the anterior edge to posterior edge had no significant difference after operation,the CR＋PR rate was 100%. Conclusions PVP is an effective minimal invasive technology,which can rapidly remit the low back pain caused by the senile osteoporosis vertebral compression fracture,reinforce the intensity of the vertebral body and stabilize the spine.
出处
《华西医学》
CAS
2010年第6期1055-1058,共4页
West China Medical Journal
