经皮穿刺骨水泥强化治疗骨质疏松性压缩性骨折骨不愈合

摘要

目的：探讨经皮穿刺靶向定位骨水泥强化治疗骨质疏松性压缩性骨折骨不愈合的安全性及短期临床疗效。方法选择2009年9月~2012年9月在我院就诊病程6个月以上的骨质疏松性椎体压缩骨折骨不愈合32例,在局麻及影像学监视下行靶向穿刺,到达骨不愈合端注入骨水泥强化,比较术前1 d,术后1 d、3个月、6个月、12个月视觉模拟评分( visual analogue score,VAS)、日常生活能力( activities of daily living,ADL)评分情况和影像学结果。结果32例共34节椎体顺利完成手术,术后影像学观察未见骨水泥渗漏。术后1 d、3个月、6个月、12个月VAS与术前1 d相比显著降低(P<0.05),术后12个月与术后3个月比较VAS显著降低(P<0.05)。术后3、6、12个月ADL评分与术前相比显著升高(P<0.05)。术前后椎体前缘、中间高度无显著性差异(P>0.05)。结论经皮穿刺靶向定位骨水泥强化治疗骨质疏松性压缩性骨折骨不愈合安全、有效。%Objective To investigate the safety and short-term clinical outcomes of percutaneous targeted positioning bone cement augmentation treatment for osteoporotic compression fracture nonunion. Methods A total of 32 cases of osteoporotic vertebral compression fracture nonunion, with clinical course of more than 6 months between September 2009 and September 2012 were selected. Under local anesthesia and radiological monitoring, targeted positioning puncture was carried out to inject bone cement to strengthen the lesions of nonunion. Visual analogue scale (VAS), activities of daily living (ADL) and radiographic results were compared among preoperative 1 day and postoperative 1 day, 3 months, 6 months, and 12 months. Results The operation was successfully completed in 34 vertebrae of the 32 cases. Postoperative radiographic observation found no cement leakage. As compared to preoperative level, the VAS scores significantly deceased at postoperative 1 day, 3 months, 6 months, and 12 months (P<0. 05), with significant decrease from postoperative 3 months to 12 months (P<0. 05). At postoperative 3 months, 6 months, and 12 months, the ADL scores significantly increased as compared to preoperation (P <0. 05). No significant differences were seen in vertebral anterior and middle height between the preoperation and postoperation (P>0. 05). Conclusion Percutaneous targeted positioning bone cement augmentation treatment for osteoporotic compression fracture nonunion is safe and effective.