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目的探讨单侧经皮椎体成形术(PVP)治疗高龄(年龄>80岁)骨质疏松性胸腰椎体压缩骨折的疗效和安全性。方法回顾性分析自2012-04—2015-05采用PVP技术治疗的56例(64个椎体)高龄骨质疏松性胸腰椎体压缩骨折。术前、术后2 d、末次随访时进行疼痛强度口头评定量表(VRS)评分和功能障碍指数(ODI)评定,并摄正侧位X线片评估Cobb角、伤椎椎体高度变化情况。结果本组手术时间24~41(31.9±5.4)min,注入骨水泥量2~5(3.4±0.8)ml。5例(5个椎体)出现无症状性骨水泥向椎体外轻度渗漏。2例出现短暂疼痛加重,1例出现局部血肿。51例(54个椎体)获得完整随访,随访时间为6~25(12.4±4.5)个月。随访中新发椎体压缩骨折6例。术前、术后2 d、末次随访时的VRS评分、ODI指数、Cobb角、伤椎椎体高度比较差异有统计学意义(P<0.05)。进一步两两比较,术后2 d、末次随访时的VRS评分、ODI指数、Cobb角、伤椎椎体高度均较术前明显改善,差异有统计学意义(P<0.05);且术后2 d与末次随访时比较差异无统计学意义(P>0.05)。结论单侧PVP技术治疗高龄骨质疏松性胸腰椎体压缩骨折是一种安全、有效的微创手术方法。
Objective To investigate the efficacy and safety of unilateral percutaneous vertebroplasty (PVP) in the treatment of osteoporotic thoracolumber vertebral compression fractures in elderly (age> 80 years). Methods 56 cases (64 vertebral bodies) of osteoporotic thoracolumbar vertebral compression fractures treated with PVP technique were retrospectively analyzed from 2012-04-2015-05. VRS score and dysfunction index (ODI) were assessed before surgery, 2 days after surgery and at the final follow-up. The Cobb angle and the vertebral body height were evaluated by lateral radiography . Results The operation time of this group was 24-41 (31.9 ± 5.4) min, and the amount of bone cement injected was 2-5 (3.4 ± 0.8) ml. In 5 cases (5 vertebrae), asymptomatic bone cement showed slight leakage to the vertebral body. 2 cases of short-term pain increased, 1 case of local hematoma. Totally 51 cases (54 vertebrae) were followed up for 6 ~ 25 (12.4 ± 4.5) months. Six cases of new vertebral compression fractures were followed up. VRS score, ODI index, Cobb angle and vertebral body height at the final follow-up and 2 days after operation were significantly different at the last follow-up (P <0.05). On the second day after operation, VRS score, ODI index, Cobb angle and vertebral body height at the final follow-up were significantly improved at the final follow-up compared with those before operation (P <0.05), and postoperative 2 There was no significant difference between d and the last follow-up (P> 0.05). Conclusions Unilateral PVP is a safe and effective minimally invasive surgical treatment of osteoporotic thoracolumbar vertebral compression fractures in elderly patients.