锤击进针单侧椎弓根穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折

摘要

Objective To assess the clinical outcome of hammer-tapping unipedicular kyphoplasty for the treatment of patients with osteoporotic vertebral compression fractures (OVCFs). Methods From May 2007 to August 2010, 23 patients suffered from OVCFs were treated with kyphoplasty via hammer-tapping unipedicular approach, including 5 males and 18 females. The age was from 58 to 87 years old, with an average of 74.4 years old. All the patients had back pain. Thirty-one vertebrae were fractured. The change of pain and radiography of the patients was followed up. Results No spinal nerve damage occurred during and after the operation. The pain relieved significantly in all patients. VAS scores were 8.4 ± 1.5 points before the surgery, 2. 2 ± 1.1 points at 24h after the surgery, and 2. 3 ± 1.2 points at the final follow-up.The comparison of the points between before and 24h after the surgery was statistically significant (P ＜0. 05 ). The comparison of the points between 24h after the surgery and at the final follow-up was not statistically significant (P ＞0. 05). The heights of the anterior column of the vertebrae were 15.60 ± 1.34 mm before the surgery, 22. 30 ± 1.02 mm 24h after the surgery, and 21.43 ±0.75 mm at the final follow-up. The kyphotic angles were 31.65 ± 1.84°before the surgery, 13.30 ± 1.53° 24h after the surgery, and 14.52 ± 1.50° at the final follow-up. There was a significant different between the preoperative and postoperative values (P ＜ 0. 05 ). Conclusion Kyphoplasty via hammer-tapping unilateral pedicular approach in patients with OVCFs is a safe and efficacious method.%目的 评估锤击进针单侧椎弓根穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床效果.方法 2007年5月～2010年8月应用锤击进针单侧椎弓根穿刺、球囊扩张、椎体后凸成形术治疗骨质疏松性椎体压缩骨折患者23例,男5例,女18例;年龄56～87岁,平均74.4岁.患者均有腰背部疼痛,共31个椎体骨折.随访观察患者的疼痛以及影像学改变情况.结果 术中、术后未出现脊髓或神经损伤,术后患者疼痛均明显缓解,术前VAS评分为(8.4±1.5)分,术后24 h为(2.2±1.1)分,随访期未为(2.3±1.2)分,术前与术后24 h比较差异有统计学意义(P<0.05),术后24 h与随访期末比较差异无统计学意义(P>0.05);椎体前缘高度术前平均为(15.60±1.34) mm,,术后24h为(22.30±1.02) mm,末次随访时为(21.43±0.75) mm;伤椎后凸角度术前平均为(31.65±1.84°),术后24h为(13.30±1.53°),末次随访时为(14.52±1.50°),术后及末次随访时与术前比较有显著性差异(P<0.05).结论 锤击进针单侧椎弓根穿刺椎体后凸成形术治疗骨质疏松性椎体压缩骨折是一种安全有效的治疗方法.