上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (10): 1258-.doi: 10.3969/j.issn.1674-8115.2010.10.018

• 论著（临床研究） • 上一篇    下一篇

微创治疗胸腰椎压缩性骨折的疗效分析

管宏新, 朱 晋, 仲 骏, 万 亮, 周秋梦, 尚 明, 杨 敏   

  1. 上海交通大学 医学院附属新华医院神经外科, 上海 200092
  • 出版日期:2010-10-25 发布日期:2010-10-27
  • 通讯作者: 仲 骏, 电子信箱: ZhongMDPhD@sjtu.edu.cn。
  • 作者简介:管宏新（1983—）, 男, 硕士生；电子信箱: grandee501@163.com。

Analysis of therapeutic effects of minimal invasive therapy for thoracic/lumbar vertebral compression fracture

GUAN Hong-xin, ZHU Jin, ZHONG Jun, WAN Liang, ZHOU Qiu-meng, SHANG Ming, YANG Min   

  1. Department of |Neurosurgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
  • Online:2010-10-25 Published:2010-10-27

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摘要：

目的 观察经皮椎体成形术（PVP）和经皮椎体后凸成形术（PKP）治疗胸腰椎压缩性骨折的临床疗效。方法 PVP或PKP微创治疗胸腰椎压缩性骨折20例（28椎）；术前、术后24 h及出院后随访时进行疼痛视觉模拟评分(VAS)；术前及出院后随访时进行 Oswestry功能障碍指数（ODI）评分；分析术后24 h及随访时患者满意度。结果 20例手术均顺利完成，其中采用PVP 4例（5椎），PKP 16例（23椎）；无严重并发症发生；获随访1～24个月，平均8个月。患者术前VAS为（8.9±0.4）分，术后24 h为（2.1±2.0）分，最后随访时为(2.2±1.9)分；术后24 h及最后随访时VAS较术前比较，差异有统计学意义（P<0.05）。最后随访时ODI明显低于术前（P<0.05），分别为(25.8±10.4)%和(56.4±10.8)%。患者术后24 h的满意率为95.0%，最后随访时为89.5%。结论 PVP/PKP治疗胸腰椎压缩性骨折，创伤小，可达到满意的止痛效果，还可预防椎体再塌陷、增强活动能力、提高患者生活质量，是一种安全有效的方法。

关键词: 经皮椎体成形术, 经皮椎体后凸成形术, 胸腰椎压缩性骨折, 微创手术

Abstract:

Objective To analysis therapeutic effects of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) on treating thoracic/lumbar vertebral compression fracture. Methods Twenty patients (28 vertebrae) suffered from thoracic/lumbar vertebral compression fracture were treated by minimal invasive therapy, PVP and PKP. Visual analog scale (VAS) of patients was measured before operation, 24 h after operation, and during follow-up. Oswestry disability index (ODI) of patients was measured before operation and during follow-up. Patients were investigated retrospectively of their satisfaction toward surgery 24 h after operation and during follow-up. Results All 20 patients received successful operation without any complication. Four patients underwent PVP (5 vertebrae) and 16 received PKP (23 vertebrae). All patients were followed up from 1 to 24 months (mean 8 months). The VAS was 8.9±0.4, 2.1±2.0, and 2.2±1.9 before operation, 24 h after operation, and at the last follow-up, respectively. Compared with preoperative scale, there was significant differences to the other two scales (P<0.05). The ODI of the last follow-up [(25.8±10.4)%] was significantly lower than ODI of before operation [(56.4±10.8)%] (P<0.05). The satisfaction rates were 95.0% 24 h after operation and 89.5% at the last follow-up, respectively. Conclusion PVP or PKP has minimal invasion with remarkable antalgic effects in treating vertebral compression fracture, which prevents vertebral collapse and improves body activity and quality of life. The operation is a safe and effective therapy.

Key words: percutaneous vertebroplasty, percutaneous kyphoplasty, thoracic/lumbar vertebral compression fracture, minimal invasive therapy