Objective To investigate the clinical effects of percutaneous kyphoplasty ( PKP ) for treating stable primary osteoporotic thoracolumbar spine burst fractures without nerve injury. Methods A total of 28 cases between January 2010 and January 2013 were retrospectively analyzed.The operation time, volume and leakage of bone cement, and other complications were recorded.Quality of life and extent of pain were evaluated by means of visual analogue scale ( VAS) and Oswestry disability index ( ODI) .The Beck index, Cobb angle, and intraspinal bone occupying rate were measured in order to observe the correction of kyphosis and vertebral height, and the position of intraspinal bone block before and after operation. Results Bone cement leakage occurred intraoperatively in 3 cases.Transient decrease of blood pressure was found in 2 cases.No severe complications occurred.At 1 day and 3 months after operation, the VAS was decreased from 8.29 ±0.56 to 2.43 ±0.49 and 1.93 ±0.40 ( t=12.812 and 14.292, P=0.000), the Beck index was increased from 0.49 ±0.06 to 0.62 ±0.07 and 0.61 ±0.08 (t=2.501, P=0.015; t=2.219, P=0.031), and the Cobb angle was decreased from 19.14 ±3.60 to 11.49 ±2.36 and 11.98 ±2.30 (t=2.693, P=0.009;t=2.538, P=0.014).At 3 months after operation, the intraspinal bone occupying rate was decreased from 17.39%±5.04% to 9.29%± 4.87%(t=2.015, P=0.048), and the ODI score was decreased from 78.29%±7.71% to 31.96%±6.75% (t=7.363, P=0.001) . Conclusion After comprehensive preoperative evaluation, reasonable following operation indications, and improved operative performance, this procedure can be used to effectively relieve the pain, improve the quality of life, correct the vertebral height and kyphosis, and increase the intraspinal bone occupying rate.%目的：探讨经皮椎体后凸成形术（ percutaneous kyphoplasty，PKP）治疗无神经损伤、稳定型、原发骨质疏松性胸腰段椎体爆裂骨折的临床治疗效果。方法回顾分析2010年1月～2013年1月此类手术28例资料，记录手术时间、骨水泥注入量和渗漏等并发症情况。手术前后通过视觉模拟评分（ visual analog scale， VAS ）、Oswestry功能障碍指数（ Oswestry disability index，ODI）评估患者疼痛及生活质量；测量Beck指数及Cobb角、椎管内骨块占位率，观察术后椎体高度恢复、后凸畸形矫正及椎管内骨块位置变化。结果术中骨水泥渗漏3例，一过性血压降低2例，无严重并发症发生。术后1天及3个月VAS从术前8．29±0．56降至2．43±0．49、1．93±0．40（t＝12．812，14．292，P均＝0．000），Beck指数从0．49±0．06升至0．62±0．07、0．61±0．08（t＝2．501，P＝0．015，t＝2．219，P＝0．031），Cobb角从19．14±3．60降至11．49±2．36、11．98±2．30（t＝2．693，P＝0．009，t＝2．538，P＝0．014）。术后3个月椎管内骨块占位率从术前17．39％±5．04％降至9．29％±4．87％（t＝2．015，P＝0．048），ODI评分从78．29％±7．71％降至31．96％±6．75％（t＝7．363，P＝0．001）。结论通过全面术前评估，合理把握适应证，改进手术操作，该术式能有效缓解疼痛，改善生活质量，纠正椎体高度及后凸畸形，不会显著增加椎管内骨块占位。
展开▼
