CAJ | 학술논문

目的：探讨经皮椎体成形术（PVP）对严重椎体压缩性骨折治疗的临床价值。方法回顾性分析2012年6月-2013年3月行PVP治疗严重椎体压缩性骨折30例患者、累及30节病变椎体的临床资料。根据椎体压缩形态分为楔形、双凹型以及长方形3种，楔形骨折采取健侧椎弓根入路，双凹形骨折采取单侧椎弓根入路，长方形压缩性骨折根据骨水泥填充情况采取单侧或双侧椎弓根入路。采用视觉模拟评分法（VAS）和WHO疼痛标准分级程度评价效果，测量压缩椎体术前高度及术后恢复高度。所有患者术后均通过门诊随访或电话随访6个月。结果30节病变椎体穿刺成功率为100%。VAS评分术前平均6．9±0．9，术后1 d、1个月、3个月、6个月分别为5．0±0．9、3．5±0．7、2．5±0．8、1．6±0．7。依据WHO标准完全缓解（CR）25例、部分缓解（PR）3例；无效2例；临床有效率（CR＋PR）为93．3%；术前压缩椎体高度为（5．77±1．09）mm；术后平均恢复高度为（14．33±2．03）mm。结论单纯PVP治疗严重椎体压缩性骨折方法可行，短期临床效果肯定。
목적：탐토경피추체성형술（PVP）대엄중추체압축성골절치료적림상개치。방법회고성분석2012년6월-2013년3월행PVP치료엄중추체압축성골절30례환자、루급30절병변추체적림상자료。근거추체압축형태분위설형、쌍요형이급장방형3충，설형골절채취건측추궁근입로，쌍요형골절채취단측추궁근입로，장방형압축성골절근거골수니전충정황채취단측혹쌍측추궁근입로。채용시각모의평분법（VAS）화WHO동통표준분급정도평개효과，측량압축추체술전고도급술후회복고도。소유환자술후균통과문진수방혹전화수방6개월。결과30절병변추체천자성공솔위100%。VAS평분술전평균6．9±0．9，술후1 d、1개월、3개월、6개월분별위5．0±0．9、3．5±0．7、2．5±0．8、1．6±0．7。의거WHO표준완전완해（CR）25례、부분완해（PR）3례；무효2례；림상유효솔（CR＋PR）위93．3%；술전압축추체고도위（5．77±1．09）mm；술후평균회복고도위（14．33±2．03）mm。결론단순PVP치료엄중추체압축성골절방법가행，단기림상효과긍정。
Objective To discuss the clinical value of percutaneous vertebroplasty (PVP) in treating severe vertebral compression fracture. Methods During the period from June 2012 to March 2013, PVP was carried out in 30 patients with severe vertebral compression fracture (30 diseased vertebrae in total). The clinical data were respectively analyzed. According to the shape of compressed vertebra , the fractures were divided into three types: wedge-shaped, double concave and oblong-shaped. For wedge-shaped fracture, PVP was performed via the pedicle access of the healthy side. For double concave type , unilateral pedicle access was used, while for oblong-shaped type unilateral or bilateral access was adopted to conduct PVP according to the distribution of the injected PMMA. The therapeutic results were evaluated by using VAS and pain degree classification standard of WHO. The preoperative and postoperative vertebral height was estimated on the lateral projection. All patients were followed up for six months at out-patient clinic or by telephone. Results The success rate of puncturing was 100%. The preoperative mean VAS was 6.9 ± 0.9. The postoperative VAS at one day, one, 3 and 6 months after the procedure was 5.0 ± 0.9, 3.5 ± 0.7, 2.5 ± 0.8 and 1.6 ± 0.7 respectively. Based on WHO pain degree classification standard, complete remission (CR) was obtained in 25 cases, partial remission (PR) in 3 cases, and invalid in 2 cases. The effective rate (CR +PR) was 93.33%. The mean preoperative height of the compressed vertebrae was (5.77 ± 1.09) mm and the mean postoperative height of the compressed vertebrae was (14.33 ± 2.03) mm. Conclusion For the treatment of severe vertebral compression fractures, percutaneous vertebroplasty is clinically feasible with reliable short-term effect.