目的：探讨体位复位、围手术期鲑鱼降钙素及延期经皮椎体后凸成形术（ PKP）治疗骨质疏松性腰椎爆裂骨折的可行性及疗效。方法自2008年12月～2012年12月，应用体位复位、围手术期鲑鱼降钙素及延期PKP治疗骨质疏松性腰椎爆裂骨折13例。结果本组获随访6～38个月，平均17.8个月。13例均顺利完成手术，末次随访均未发现邻近椎体新发骨折。本组未出现骨水泥渗漏，未对前方大血管造成危害，术后无神经症状及特殊不适。患者疼痛视觉模拟评分（ VAS）术后第7天和末次随访时情况较术前明显改善，差异有统计学意义（ P ＜0.01）；椎体前缘高度、矢状面 Cobb 角手术前后比较，差异无统计学意义（ P ＞0.05）。结论体位复位、围手术期鲑鱼降钙素及延期PKP治疗骨质疏松性腰椎爆裂骨折，手术创伤小，安全可行。术后伤椎即刻稳定，止痛效果好，患者可早期下床活动，避免常见的卧床并发症。%Objective To explore the feasibility and efficacy of postural reduction combined with perioperative salmon calcitonin and delayed percutaneous kyphoplasty ( DPKP) for the treatment of osteoporotic lumbar burst fractures .Methods Thirteen patients with osteoporotic lumbar burst fractures , who were treated with postural reduction combined with perioperative salmon calcitonin and DPKP from December 2008 to December 2012, were selected.Results The follow-up of all the patients ranged from 6 to 38 months, with an average of 17.8 months.The operations of all these 13 patients were successful , and no new fractures of adjacent vertebral bodies were observed at their last follow-up.Neither leakage of bone cement , injury of front major vessels , nor postoperative neurological symptoms and discomfort were observed in all these patients .The pain visual analogue scale ( VAS) at the 7 th day after the operation and at the last follow-up was significantly lower than that before the operation ( P<0.01 ) .The comparison of the front vertebral height and sagittal Cobb angle before and after the operation showed no significant difference ( P>0.05 ) .Conclusion In the treatment of osteoporotic lumbar burst fractures , postural reduction combined with perioperative salmon calcitonin and DPKP are less invasive , safe, and feasible .The injured vertebrae obtain immediate stability after surgery , and the analgesic effect is good .Patients can do exercise off the bed at the early stage , which can avoid common complications of bed rest .
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