CAJ | 학술논문

目的：研究单侧经皮椎体成形术（Percutaneous Vertebroplasty，PVP）治疗老年陈旧性骨质疏松性压缩骨折的临床疗效。方法回顾性分析2011年1月至2012年12月收治的资料完整的患者31例，男8例，女23例；年龄51～84岁，平均66.3岁。所有病人取俯卧位，局麻下行单侧穿刺经皮椎体成形术。测量椎体高度的恢复情况和后凸改善情况，视觉模拟评分评价疼痛缓解程度，活动能力评分检测活动改善情况，并对并发症进行分析。结果所有患者术后均获12个月随访。术前和术后椎体前高度分别为15.8±7.2 mm和16.1±7.4 mm；椎体中间高度分别为16.5±7.1 mm和16.7±7.1 mm；椎体后高度分别为26.9±5.0 mm和26.9±4.9 mm；后凸角度分别为11.1±7.2度和11.3±6.8度。术前和术后差异无统计学意义（P>0.05）。术前、术后1 d、术后1周、术后3月和术后12月，VAS分别为5.7±1.4、3.0±1.4、2.6±1.8、3.2±2.1和3.2±2.0；活动能力评分分别为2.0±0.7、1.2±0.4、1.2±0.4、1.2±0.4和1.4±0.5。术前和术后差异有统计学意义（P<0.05）。结论经皮椎体成形术可以部分改善老年慢性疼痛性椎体压缩性骨折患者的活动功能，减轻疼痛；但对椎体高度的恢复和后凸角度的改善无明显作用。
목적：연구단측경피추체성형술（Percutaneous Vertebroplasty，PVP）치료노년진구성골질소송성압축골절적림상료효。방법회고성분석2011년1월지2012년12월수치적자료완정적환자31례，남8례，녀23례；년령51～84세，평균66.3세。소유병인취부와위，국마하행단측천자경피추체성형술。측량추체고도적회복정황화후철개선정황，시각모의평분평개동통완해정도，활동능력평분검측활동개선정황，병대병발증진행분석。결과소유환자술후균획12개월수방。술전화술후추체전고도분별위15.8±7.2 mm화16.1±7.4 mm；추체중간고도분별위16.5±7.1 mm화16.7±7.1 mm；추체후고도분별위26.9±5.0 mm화26.9±4.9 mm；후철각도분별위11.1±7.2도화11.3±6.8도。술전화술후차이무통계학의의（P>0.05）。술전、술후1 d、술후1주、술후3월화술후12월，VAS분별위5.7±1.4、3.0±1.4、2.6±1.8、3.2±2.1화3.2±2.0；활동능력평분분별위2.0±0.7、1.2±0.4、1.2±0.4、1.2±0.4화1.4±0.5。술전화술후차이유통계학의의（P<0.05）。결론경피추체성형술가이부분개선노년만성동통성추체압축성골절환자적활동공능，감경동통；단대추체고도적회복화후철각도적개선무명현작용。
Objective To evaluate the efficiency of treatment of chronic and painful vertebral compression fractures with percutaneous vertebroplasty in senior patients. Methods This retrospective study included 31 cases (8 male and 23 females, average age 66.3 years old) with chronic and painful vertebral compression fractures in the period of January 2011 to November 2012. All operations were finished successfully under local anesthesia on the surgical area with 1%lidocaine at prone position. body height and kyphotic angle of vertebral bodies were measured before and after operation,pain levels and activity was evaluated by VAS score and locomotor activity score before the operation, 1day, 1week,3 and 12 months after the operation. Complications of vertebroplasty also were recorded. Results All patients were followed up for 12 months. Respective pre-and post-treatment, the average anterior height of the vertebral body were 15.8±7.2mm and 16.1±7.4mm;and the average medium height of the vertebral body were 16.5±7.1mm and 16.7±7.1mm;and the average posterior height of the vertebral body were 26.9±5.0mm and 26.9±4.9mm;the average Cobb angle were 11.1±7.2°and 11.3± 6.8°. There was no significant difference between preoperation and postoperation (P>0.05). At the preoperation, 1 day, 1 week, 3 and 12 months postoperation, The average VAS score were 5.7±1.4、3.0±1.4、2.6±1.8、3.2±2.1and 3.2±2.0;locomotor activity score y were 2.0±0.7、1.2±0.4、1.2±0.4、1.2±0.4 and 1.4±0.5. the difference was statistically significant(P<0.05). Cement leakage happened in 5 patients without Neurological complications. Conclusion Percutaneous vertebroplasty partly decreases pain and increases mobility in senior patients with chronic painful vertebral compressive fractures, but has no effect on restoring vertebral height and kyphotic angle.