BACKGROUND:Percutaneous vertebroplasty with injection of bone cement is to reinforce the vertebral stability after vertebral compression fractures, to prevent further vertebral colapse, thereby playing a significant analgesic effect, but it is prone to develop complications such as bone cement leakage. OBJECTIVE: To evaluate the efficacy and safety of percutaneous vertebroplasty with injection of polymethyl methacrylate bone cement for treating osteoporotic thoracolumbar vertebral compressive fractures. METHODS:Totaly 65 cases of osteoporotic thoracolumbar vertebral compressive fractures were treated by percutaneous vertebroplasty with injection of polymethylmethacrylate under DSA fluoroscopy image guiding. Visual analog scale score, Oswesty dysfunction index, vertebral height, vertebral kyphosis angle changes, as wel as bone cement leakage were detected before and after treatment. RESULTS AND CONCLUSION:At 1 day after treatment, the visual analogue scale score and Oswesty disability index decreased rapidly, which was significantly lower than that before treatment (P < 0.01); after 1 month, the visual analog scale score and Oswesty disability index were further reduced, and there was a significant difference at 1 day and 1 month after treatment (P < 0.05). However, there was no difference in the visual analogue scale score and Oswesty disability index at 1, 3, 6 months after treatment (P > 0.05). The anterior vertebral height and the central height were restored remarkable at 3 months after treatment, and the Cobb angle was obviously corrected, as compared with those before treatment (P < 0.05); at 6 months after treatment, the vertebral height and Cobb angle mostly remained stable. Imaging examination showed that a smal amount of paravertebral bone cement leakage occurred in six cases, including two cases of paravertebral soft tissue leakage and four cases of adjacent intradiscal leakage. But there were no obvious clinical symptoms and no nerve injury. The results suggest that percutaneous vertebroplasty with injection of polymethyl methacrylate bone cement can relieve the pain of patients with osteoporotic vertebral compression fractures, increase the vertebral height in the majority of patients, improve kyphotic deformity, and lead to less adverse reactions.%背景：经皮椎体成形通过注入骨水泥材料强化压缩骨折椎体的稳定性，防止椎体进一步塌陷，发挥显著的止痛效果，但易出现骨水泥渗漏等并发症。 目的：进一步评估聚甲基丙烯酸甲酯骨水泥经皮椎体成形治疗骨质疏松性胸腰椎压缩骨折的疗效及安全性。方法：65例骨质疏松性胸腰椎椎体压缩骨折患者在 DSA 机引导下行聚甲基丙烯酸甲酯骨水泥经皮椎体成形治疗，对比治疗前后目测类比评分、Oswesty 功能障碍指数、椎体高度、椎体后凸角度变化，以及骨水泥渗漏情况。 结果与结论：治疗后1 d目测类比评分和Oswesty功能障碍指数较治疗前降低(P<0.01)，治疗后1个月时目测类比评分和Oswesty功能障碍指数进一步降低，与治疗后1 d比较差异有显著性意义(P<0.05)，治疗后1，3，6个月时间点两两比较差异无显著性意义(P>0.05)。与治疗前比较，治疗后3 d椎体前缘高度和中央高度明显恢复(P<0.05)，Cobb角明显矫正(P <0.05)，至6个月后大部分椎体高度和Cobb角仍保持稳定。影像学复查显示椎旁骨水泥少量渗漏6例，其中椎旁软组织内渗漏2例，相邻椎间盘内渗漏4例，均无明显临床症状，未见神经损伤病例。提示聚甲基丙烯酸甲酯骨水泥经皮椎体成形可迅速缓解骨质疏松性椎体压缩骨折患者的疼痛，提高多数椎体的高度，改善后凸畸形且不良反应少。
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