CAJ | 학술논문

目的评价单侧椎弓根旁入路椎体后凸成形术治疗疼痛性胸腰椎骨质疏松压缩骨折止痛效果和对椎体高度恢复的影响.方法 2007年5月至2011年3月应用单侧椎弓根旁入路椎体后凸成形术治疗胸腰椎骨质疏松压缩骨折患者96例118个椎体(T4-L4),年龄55～ 82岁(平均67岁),有症状的节段均做MRI证实.手术前和术后48 h、术后3个月随访分别进行视觉模拟评分(VAS)评分测定,测量侧位X线片测量骨折椎体前、中部的高度.统计学分析采用SPSS 13.0,计量数据采用配对t检验.结果术后3个月患者VAS评分从8.1分降至2.1分,手术后118椎前、中部的高度增加到了原椎体高度的75.8％±19.8％和71.2％±21.4％.术前与术后24h、术后1周、术后3个月VAS评分差异有统计学意义(P＜0.05),术后24h、术后1周、术后3个月VAS评分差异无统计学意义(P＞0.05).术前与术后48 h、术后3个月椎体前部、中部高度差异有统计学意义(P＜0.05),术后48 h与术后3个月椎体前部、中部高度差异无统计学意义(P＞0.05).结论单侧椎弓根旁入路椎体后凸成形术可以改善运动功能和减轻疼痛,可安全增加椎体高度,恢复老年患者行走能力.
목적 평개단측추궁근방입로추체후철성형술치료동통성흉요추골질소송압축골절지통효과화대추체고도회복적영향.방법 2007년5월지2011년3월응용단측추궁근방입로추체후철성형술치료흉요추골질소송압축골절환자96례118개추체(T4-L4),년령55～ 82세(평균67세),유증상적절단균주MRI증실.수술전화술후48 h、술후3개월수방분별진행시각모의평분(VAS)평분측정,측량측위X선편측량골절추체전、중부적고도.통계학분석채용SPSS 13.0,계량수거채용배대t검험.결과 술후3개월환자VAS평분종8.1분강지2.1분,수술후118추전、중부적고도증가도료원추체고도적75.8％±19.8％화71.2％±21.4％.술전여술후24h、술후1주、술후3개월VAS평분차이유통계학의의(P＜0.05),술후24h、술후1주、술후3개월VAS평분차이무통계학의의(P＞0.05).술전여술후48 h、술후3개월추체전부、중부고도차이유통계학의의(P＜0.05),술후48 h여술후3개월추체전부、중부고도차이무통계학의의(P＞0.05).결론 단측추궁근방입로추체후철성형술가이개선운동공능화감경동통,가안전증가추체고도,회복노년환자행주능력.
Objective To evaluate the effects of relieving pains and restoring vertebral heights of percutaneous balloon kyphoplasty by extrapedicular approach as a minimally invasive treatment in patients with painful osteoporotic vertebral compressive fractures (OVCF).Methods A retrospective analysis was conducted for 96 consecutive patients.There were 64 females and 32 males with a mean age 67 years (range:55-82).Symptomatic levels were identified by correlating their clinical presentations with the findings of magnetic resonance imaging (MRI).The interval between onset of symptoms and surgical intervention ranged from 2 days to 4 months.A total of 118 levels(56 thoracic,62 lumbar)were treated in this cohort.Immediate and postoperative 3-month follow-up visits were conducted.Visual analog scale (VAS) pain scores,preoperative and postoperative anterior,midline vertebral heights for fractured vertebrae were measured on lateral radiographs to evaluate the procedural outcomes.Results There was swift pain relief associated with evident augmentation in weight-bearing resistance.Pain decreased from 8.1 to 2.1 points.Through kyphoplasty,the anterior,midline vertebral heights of 118 fractured vertebral bodies increased up to (75.83 ± 19.84) ％ and (71.23 ± 21.45) ％ respectively.None of them had worsening of fracture-induced narrowing of spinal canal.No device-related major complications occurred.Conclusion Percutaneous kyphoplasty through an extrapedicular approach results in immediate clinical improvement of mobility and pain relief.It safely increases vertebral body height and quickly returns geriatric patients to higher activity levels,increased independence and better quality-of-life.And its short-term outcomes are excellent.