微创医学

目的观察单侧穿刺经皮椎体成形术治疗新鲜骨质疏松性椎体压缩骨折的临床效果。方法选取78例(96个椎体)新鲜骨质疏松性椎体压缩骨折患者进行单侧穿刺经皮椎体成形术治疗,观察术前、术后72 h、6周、1年疼痛VAS评分、Oswstry功能障碍指数、椎体后凸Cobb’s角变化,以及术后1年内再次骨折情况。结果随访1年,所有患者术后疼痛均缓解,术前、术后72 h、6周、1年VAS评分分别为7.53±1.21、3.21±1.30、3.01±1.06、2.54±1.10;ODI值分别为81±9.31、32.9±7.3、32.5±8.31、31.0±6.9,两项指标手术治疗前后对比差异有统计学意义(P<0.05),术后差异无统计学意义(P>0.05)。手术前后X线片测量椎后突Cobb’s角略有变化,但差异无统计学意义(P>0.05)。术后1年内有11例相邻椎体发生骨折。结论单侧穿刺椎体成形术有创伤小、手术时间短的优点,术后即可有效缓解疼痛,恢复患者正常生活功能,是治疗新鲜骨质疏松性椎体压缩骨折的有效方法。

Objective To observe the effect of unilateral puncture percutaneous vertebroplasty in the treatment of fresh osteoporotic vertebral compression fractures． Methods Unilateral puncture percutaneous vertebroplasty were performed in 78 ( 96 vertebrae) cases of fresh osteoporotic vertebral compression fractures． Visual analog pain scores( VAS) ，Oswestry disability index ( ODI) ，and vertebral kyphosis angle ( Cobb’ s angle) before，72h，6 weeks，and one year after operation were observed． Secondary fracture after one year was recorded． Results VAS was 7． 53 ± 1． 21，3 ． 21 ± 1． 30，3 ． 01 ± 1． 06，2 ． 54 ± 1． 10，and ODI was 81 ± 9． 31， 32． 9 ± 7． 3， 32． 5 ± 8． 31，31． 0 ± 6． 9， respectively，for the time point of before，72h，6 weeks，and one year after operation． Both VAS and ODI showed significant difference before and after operation，but not among those after operation． Cobb’s angle indicated by X ray changed a little after operation，but without statistical significance． After one year follow-up，all patients received pain relief，but 11 adjacent vertebra fractures were observed． Conclusion Unilateral vertebroplasty has the advantages of little trauma and short operation time， and postoperatively can effectively relieve pain，and restore function，indicating it as an effective method in the treatment of fresh osteoporotic vertebral compression fractures．