CAJ | 학술논문

目的探讨经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折的临床疗效. 方法 2007年3月-2013年2月采用PKP治疗椎体骨质疏松性压缩骨折210例,其中男100例,女110例;年龄55 ～91岁,平均72.5岁.其中单椎骨折180例,双椎体骨折20例,3椎体骨折10例,共250个椎体,分布范围T6～ L5.每个椎体注入骨水泥3～5 ml,平均4 ml.检测术前术后椎体高度、Cobb角和视觉模拟评分(VAS),评价治疗效果. 结果术后随访6～15个月,平均11个月,患者胸腰背部疼痛均明显缓解或消失.术前患者VAS(8.7±1.2)分,椎体前缘高度丢失(11.0±3.2)mm,椎体中部高度丢失(8.6 ±1.1)mm,Cobb角(29.8±4.5)°;术后分别为(2.6±0.7)分、(5.5 ±0.8)mm、(3.3±1.0) mm、(16.7±3.4)°(P＜0.01).4例骨水泥椎间隙渗漏未出现疼痛不适;2例骨水泥椎管内渗漏出现下肢神经刺激症状,对症治疗后恢复. 结论 PKP可重建骨折椎体高度,增加椎体刚度和稳定性,有效缓解胸腰背部疼痛,是治疗老年骨质疏松性椎体压缩骨折的有效方法.
목적 탐토경피추체후철성형술(PKP)치료노년골질소송성추체압축골절적림상료효. 방법 2007년3월-2013년2월채용PKP치료추체골질소송성압축골절210례,기중남100례,녀110례;년령55 ～91세,평균72.5세.기중단추골절180례,쌍추체골절20례,3추체골절10례,공250개추체,분포범위T6～ L5.매개추체주입골수니3～5 ml,평균4 ml.검측술전술후추체고도、Cobb각화시각모의평분(VAS),평개치료효과. 결과 술후수방6～15개월,평균11개월,환자흉요배부동통균명현완해혹소실.술전환자VAS(8.7±1.2)분,추체전연고도주실(11.0±3.2)mm,추체중부고도주실(8.6 ±1.1)mm,Cobb각(29.8±4.5)°;술후분별위(2.6±0.7)분、(5.5 ±0.8)mm、(3.3±1.0) mm、(16.7±3.4)°(P＜0.01).4례골수니추간극삼루미출현동통불괄;2례골수니추관내삼루출현하지신경자격증상,대증치료후회복. 결론 PKP가중건골절추체고도,증가추체강도화은정성,유효완해흉요배부동통,시치료노년골질소송성추체압축골절적유효방법.
Objective To evaluate the clinical efficacy of percutaneous kyphoplasty (PKP) in surgical treatment of osteoporotic thoracolumbar vertebral compression fracture in the elderly.Methods From March 2007 to February 2013,210 cases (100 males and 110 females;55-91 years of age,mean 72.5 years) of osteoporotic vertebral compression fracture were treated with PKP.Single-segment fracture was observed in 180 cases,two-segment fracture in 20 cases and three-segment fracture in 10 cases.Lesion involved in 250 vertebrae located in the T6-L5 segment.Bone cement injected into each vertebra was 3-5 ml (mean,4 ml).Treatment effects were assessed with vertebral height,Cobb angle and visual analogue score (VAS).Results At the follow-up of 6-15 months (mean 11 months),thoracic back pain significantly alleviated or disappeared.After operation,improvements were observed in VAS [(8.7 ± 1.2) points vs (2.6 ±0.7) points],anterior vertebral height loss [(11.0 ±3.2) mm vs(5.5 ± 0.8) mm],central vertebral height loss [(8.6 ± 1.1)mm vs (3.3 ± 1.0) mm],and Cobb angle [(29.8 ± 4.5) ° vs (16.7 ± 3.4) °] (P ＜ 0.01).Four patients appeared no pain or numbness in lower limbs although cement leak into disc.Whereas two patients had lower extremity nerve irritation because of cement leak into the spinal canal and recovered after symptomatic treatment.Conclusion PKP is an effective method for treatment of osteoporotic vertebral compression fracture in the elderly,for it can rebuild vertebral height,increase vertebral rigidity as well as stability and relieve thoracic back pain.