双侧椎体后凸成形术在骨质疏松性椎体 压缩性骨折的临床应用

王 志苗¹, 郭 涛²
1、贵州中医药大学
2、贵州省人民医院

摘要

目的:探讨经双侧椎弓根入路行椎体后凸成形术（PKP）在骨质疏松性椎体压缩性骨折的临床应用。
方法:选取经双侧椎弓根入路行PKP治疗的骨质疏松性椎体压缩性骨折患者49例（62个椎体）的临床资料。在X
线侧位片上测算伤椎的术前、术后高度,计算VAS、ODI评分指标的变化。结果:1.伤椎高度:术前前缘、中部、
后缘高度分别为:（17.6±5.3）mm、（15.0±5.0）mm、（25.8±4.6）mm;术后伤椎前缘、中部、后缘高度分别为:
（20.0±5.3）mm、（17.6±4.6）mm、（26.7±4.9）mm,术后伤椎高度较术前相比有较明显提升（P＜0.01）。2.VAS
评分:6.7±1.3分（术前）、3.2±1.1分（术后）,VAS评分较术前显著降低（P＜0.01）。3.ODI评分:26.4±3.6分（术
前）、11.3±1.5分（术后）,术后ODI评分较术前显著降低（P＜0.01）。结论:临床应用经双侧椎弓根入路椎体后凸
成形术治疗骨质疏松性压缩性骨折疗效确切,在有效缓解患者腰背痛、改善活动受限状况的同时重建伤椎高度。

关键词

经皮椎体后凸成形术;伤椎高度;压缩性骨折;骨质疏松

参考

[1]Edidin Avram Allan,Ong Kevin L,Lau Edmund et al.

Morbidity and Mortality After Vertebral Fractures: Comparison

of Vertebral Augmentation and Nonoperative Management in

the Medicare Population.[J] .Spine (Phila Pa 1976), 2015, 40:

1228-41.

[2]Kado D M,Browner W S,Palermo L et al. Vertebral

fractures and mortality in older women: a prospective study.

Study of Osteoporotic Fractures Research Group.[J] .Arch

Intern Med, 1999, 159: 1215-20.

[3]Edidin Avram Allan,Ong Kevin L,Lau Edmund et al.

Morbidity and Mortality After Vertebral Fractures: Comparison

of Vertebral Augmentation and Nonoperative Management in

the Medicare Population.[J] .Spine (Phila Pa 1976), 2015, 40:

1228-41.

[4]Allen C,Glasziou P,Del Mar C,Bed rest: a potentially

harmful treatment needing more careful evaluation.[J] .Lancet,

1999, 354: 1229-33.

[5] 杨 惠 林，HansenAYuan， 王 根 林， 梅 昕， 孟 斌，

姜为民，陈亮，唐天驷 .Catheterfabric 椎体后凸成形术的

初步临床应用 [J]. 中华创伤骨科杂志，2010（02）：105-

108.

[6]McGirt Matthew J,Parker Scott L,Wolinsky Jean_xfffe_Paul et al. Vertebroplasty and kyphoplasty for the treatment of

vertebral compression fractures: an evidenced-based review of

the literature.[J] .Spine J, 2009, 9: 501-8.

[7]Lieberman I H,Dudeney S,Reinhardt M K et al. Initial

outcome and efficacy of "kyphoplasty" in the treatment of

painful osteoporotic vertebral compression fractures.[J] .Spine

(Phila Pa 1976), 2001, 26: 1631-8.

[8]Rousing Rikke,Hansen Karina L,Andersen Mikkel

O et al. Twelve-months follow-up in forty-nine patients

with acute/semiacute osteoporotic vertebral fractures treated

conservatively or with percutaneous vertebroplasty: a clinical

randomized study.[J] .Spine (Phila Pa 1976), 2010, 35: 478-82.

[9]Berenson James,Pflugmacher Robert,Jarzem Peter et al.

77

预防医学研究: 2021年3卷12期

ISSN: 2705-0440(Print); 2705-0459(Online)

Balloon kyphoplasty versus non-surgical fracture management

for treatment of painful vertebral body compression fractures

in patients with cancer: a multicentre, randomised controlled

trial.[J] .Lancet Oncol, 2011, 12: 225-35.

[10]Zhu R-S,Kan S-L,Ning G-Z et al. Which is the

best treatment of osteoporotic vertebral compression fractures:

balloon kyphoplasty, percutaneous vertebroplasty, or nonsurgical treatment? A Bayesian network meta-analysis.[J]

.Osteoporos Int, 2019, 30: 287-298.

[11] 王辉 . 椎体后凸成型术治疗椎体压缩性骨折的疗

效研究 [J]. 中国继续医学教育，2020，12（10）：97-99

[12] 殷刚，杨雷，刘海峰，朱建国 . 经皮椎体后凸成

形术治疗椎体压缩骨折手术时机的选择及临床疗效分析

[J]. 贵州医药，2016，40（05）：501-503.

[13] 李玉波，陈宾 . 不同手术时机椎体后凸成形术治

疗老年胸腰椎压缩性骨折的疗效对比 [J]. 中国老年学杂

志，2019，39（07）：1611-1614.

[14]Crandall Dennis,Slaughter Douglas,Hankins P J et al.

Acute versus chronic vertebral compression fractures treated

with kyphoplasty: early results.[J] .Spine J, 2004, 4: 418-24.

[15] 王宇翔，徐海栋，赵建宁 . 球囊后凸成形术治疗

骨质疏松椎体压缩性骨折 [J]. 中国矫形外科杂志，2019，

v.27；No.480（22）：2088-2090.

[16]Baroud Gamal,Bohner Marc,Biomechanical impact of

vertebroplasty. Postoperative biomechanics of vertebroplasty.[J]

.Joint Bone Spine, 2006, 73: 144-50.

[17]Zhao G,Liu X,Li F,Balloon kyphoplasty versus

percutaneous vertebroplasty for treatment of osteoporotic

vertebral compression fractures (OVCFs).[J] .Osteoporos Int,

2016, 27: 2823-2834.