应用Fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折

Fabric pod kyphoplasty for osteoporotic vertebral fractures

中文关键词:  椎体骨折  后凸成形术  骨质疏松症

英文关键词:Vertebral fracture  Kyphoplasty  Osteoporosis

中文摘要:

  【摘要】　目的：评估应用fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折的临床效果。方法：2007年12月～2010年4月应用fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折患者13 例共15个椎体，男2例，女11例；年龄56～81岁，平均72.2岁；T9 1例，T11 2例，T12 5例，L1 5例，L2 2例；椎体后壁骨折2个椎体，其余椎体后壁完整。均无脊髓和神经受损的症状和体征，疼痛节段椎体MRI脂肪抑制序列均为高信号，VAS评分为8.9±1.4分，Oswestry功能障碍指数（ODI）为（86.1±9.7）%，伤椎椎体前缘高度为14.50±1.34mm，伤椎后凸Cobb角度为28.50°±1.85°。随访观察患者的VAS评分、ODI及影像学改变情况。结果：患者均安全耐受手术，手术时间每节段36～58min，平均45min。未出现骨水泥渗漏，无感染、血管栓塞、脊髓或神经损伤等并发症。术后患者疼痛均明显缓解，术后24h VAS为2.1±1.3分，ODI为（30.5±7.6）%，伤椎椎体前缘高度为23.20±1.12mm，伤椎后凸Cobb角度为11.30±1.40°，与术前比较均有差异性差异（P<0.05）。随访6~22个月，平均12个月，末次随访时VAS为2.2±1.5分，ODI为（32.7±8.4）%，伤椎椎体前缘高度为22.82±0.85mm，伤椎后凸Cobb角度为12.48°±0.70°，与术前比较均有显著性差异（P<0.05），与术后24h比较均无显著性差异（P>0.05）。结论：应用fabric pod行椎体后凸成形术治疗骨质疏松性椎体骨折可显著缓解疼痛、有效恢复骨折椎体的高度，避免骨水泥渗漏，近期疗效满意。

英文摘要:

  【Abstract】　Objective：To evaluate the clinical and radiographical outcomes of fabric pod kyhoplasty for osteoporotic vertebral fractures（OVFs）.Method：13 patients（11 females and 2 males） who sustained OVFs underwent fabric pod kyphoplasty between December 2007 and April 2010.The mean age was 72.2 years old（range，56-81 years）.A total of 15 painful OVFs（1 T9，2 T11，5 T12，5 L1，2 L2） were enrolled in our study.Except ford 2 patients，all patients had an intact posterior vertebral wall，and MRI showed marrow edema on fat-saturated T2-weighted sequences.Preoperative and postoperative of visual analogue scores（VAS），Oswestry disability index（ODI），and radiographic results were compared.Result：All patients got significant pain relief. The VAS score improved from 8.9±1.4 to 2.1±1.3 after operation，and was 2.2±1.5 at the finall follow-up. There was significant improvement between the preoperative and postoperative values（P<0．05），but no difference between postoperative and final follow-up values were noted（P>0．05）．Compared with preoperative ODI scores，the postoperative ones showed significant improvement[（86.1±9.7）% vs. （30.5±7.6）%]. The final follow-up ODI was （32.7±8.4）%.The height of anterior column of the vertebrae increased from pre-operative 14.50±1.34mm to post-operative 23.20±1.12mm and 22.82±0.85mm at final follow-up.There was significant improvement between the preoperative and postoperative ODI values（P<0．05），but no difference between the postoperative and final follow-up values were noted（P>0．05）．The kyphotic angle improved from pre-operative 28.50°±1.85° to post-operative 11.30°±1.40° and 12.48°±0.70° at final follow-up.There was significant improvement between preoperative and postoperative values（P<0．05），but no difference between the postoperative and final follow-up values were noted（P>0．05）．Conclusion：Fabric pod kyphoplasty is safe and reliable for painful OVFs，which can prevent bone cement leakage and ensure satisfying short-term results.