CAJ | 학술논문

目的探讨经皮椎体后凸成形术(PKP)治疗胸腰椎骨折的方法及疗效.方法回顾性分析2004年1月至2011年11月广东医学院附属南山医院收治的胸腰椎骨质疏松性椎体压缩性骨折患者96例共110个椎体,均采用经椎弓根单侧PKP或合并另外一侧椎体成形术(PVP)的方法进行治疗,并对其术后椎体前缘的高度恢复值、VAS和Oswestry评分的疼痛改善情况、骨水泥的渗漏方式及比率进行了分析.结果所有110个椎体均穿刺成功,所有96个患者手术效果均满意,椎体骨水泥分布比较理想,手术时间约20 ～ 40 min/椎体,骨水泥注射量约5.4 ml/椎体,术后VAS和Oswestrv疼痛评分较术前均明显缓解(P＜0.01),椎体前缘高度明显改善(P＜0.01),手术的主要并发症是骨水泥渗漏,大部分渗漏发生在椎体前缘及前侧的静脉丛,总体发生率为56.3％.随访36个患者的40个椎体,1例有相邻椎体的骨折发生,1例患者治疗椎的前上缘(无骨水泥填充部位)发生了轻度的塌陷,但患者无不适.结论 PKP或结合PVP是一种安全、方便、有效的治疗骨质疏松性椎体压缩性骨折的方法.
목적 탐토경피추체후철성형술(PKP)치료흉요추골절적방법급료효.방법 회고성분석2004년1월지2011년11월엄동의학원부속남산의원수치적흉요추골질소송성추체압축성골절환자96례공110개추체,균채용경추궁근단측PKP혹합병령외일측추체성형술(PVP)적방법진행치료,병대기술후추체전연적고도회복치、VAS화Oswestry평분적동통개선정황、골수니적삼루방식급비솔진행료분석.결과 소유110개추체균천자성공,소유96개환자수술효과균만의,추체골수니분포비교이상,수술시간약20 ～ 40 min/추체,골수니주사량약5.4 ml/추체,술후VAS화Oswestrv동통평분교술전균명현완해(P＜0.01),추체전연고도명현개선(P＜0.01),수술적주요병발증시골수니삼루,대부분삼루발생재추체전연급전측적정맥총,총체발생솔위56.3％.수방36개환자적40개추체,1례유상린추체적골절발생,1례환자치료추적전상연(무골수니전충부위)발생료경도적탑함,단환자무불괄.결론 PKP혹결합PVP시일충안전、방편、유효적치료골질소송성추체압축성골절적방법.
Objective To discuss the methods and the effects of percutaneous kyphoplasty(PKP)in the treatment of thoracolumbar osteoporotic vertebral compression fractures ( OVCFs).Methods Retrospective analysis was made on 110 vertebrae in 96 thoracolumbar OVCFs patients undergoing transpedicular unilateral PKP or PKP combined with percutaneous vertebroplasty(PVP) from Jan.2004 to Nov.2011.We analyzed the change of the anterior heights of the vertebra,the clinical outcomes using VAS and Oswcstry bcforc and after the treatment,and the rate of cement leakage.Results 85 vertebrae were treated with the PKP sucessfully,and 25 vertebraewere treated with both PKP and PVP sucessfu]ly.All patients were satisfied with the diffusion of the cement.Theoperation time of each vertebra was about 20-40 minutes for one side.The injection volume of of each vertebrawas about 5.4 ml.According to VAS and Oswestry,the pain was alleviated obviously after the operation ( P ＜0.01) and the anterior heights of the vertebrae changed ( P ＜ 0.01).The leakage of the cement was the only complication in these patients and most of the leakage happened at the anterior of the vertebrae and the vein nearby.The overall rate of the leakage was 56.3％.For the 40 vertebrae of the 36 patients that were followed up,1patient had fracture in a neighbor vertebra and 1patient had subsidence in the upper anterior edge of the treated vertebra where there was no cement filled in,but the patient had no discomfort.Conclusion PKP or PKP combined with PVP are safe,convenient and effective methods in treating OVCFs.