经皮椎体成形与术治疗老年骨质疏松性椎体压缩骨折.docVIP

经皮椎体成形术治疗老年骨质疏松性椎体压缩骨折 广东省阳江市中医院 滕范文 冯运垒 （滕范文现调入广东东莞市常平医院） [摘要]目的：总结经皮椎体成形术（PVP）治疗老年骨质疏松性椎体压缩骨折的临床效果。方法：26例（32个椎体）骨质疏松性椎体压缩骨折患者，在C型臂X线机透视下，行经皮经椎弓根途径椎体成形术治疗。其中8例患者（8椎体）在硬外麻下行体位及手法复位后再行PVP治疗，每椎体注射骨水泥（PMMA）3.5~8ml。结果：在C型臂X线机透视下行PVP，操作容易，手术时间短，每椎体20-40分钟；体位及手法复位后行PVP者，椎体高度大部分恢复；23例病人腰痛在术后24h内消失，24h后即离床活动，3例陈旧性骨折患者腰痛部分缓解，偶服止痛药，随访3-32个月无症状复发及椎体高度丢失。并发骨水泥椎旁渗漏4例4椎体，椎前引流静脉渗漏2例2椎体，无临床症状。穿剌针抽出脑脊液1例，改行另侧穿剌成功。结论：①经皮椎体成术治疗老年骨质疏松性椎体压缩骨折具有微创、简单、见效快、疗效肯定的优点；②体位及手法复位后行PVP，能大部分恢复椎体高度，适合于年龄相对较轻,椎体楔形压缩较多的患者; ③只要操作熟练，单侧椎弓根穿刺即能达到临床目的。 [关键词]骨质疏松症；椎体压缩骨折；经皮椎体成形术；闭合复位。 Percutaneous vertebroplasty for treating osteoporotic vertebral compressive fractures in senile population Guangdong Yangjiang Hospital of T.C.M Teng Fanwen Feng Yunlei Abstract: Objective To summarize the clinical efficacy of percutaneous vertebroplasty（PVP） for treating vertebral body compression fracture （VCF） in aged osteoporosis. Methods 26 old patients (32 vertebrae) with VCF were treated with PVP with the help of C-arm fluoroscopybody position and manipulative reduction ,and injected with the polymethylmethacrylate （PMMA）about 3.5~8ml each vertebrae. Results: PVP with C-arm fluoroscopy , could be operated easily ,the time of operation was very short,taking only 20-40 minutes each vertebrae;And the vertebral height of the later was mostly recovered ;Of the 26 cases, 23 patients obtained fully relief of pain within 24 hours ,and exercised out of bed after 24 hours ;The painful symptom of 3 oboslete fracture patients was relieved partly,only taking acesodyne sometimes. Follow-ups for 3-32 months found no recurrence of the symptoms, X-ray films showed no loss of the vertebral height . Bone cement leaked to the side of vertebrae in 4 cases (4 vertebrae )and to anter-draining vein in 2 cases (2 vertebrae), but there were no clinical symptoms. CSF was drew out in one patient ,and we succeeded in puncturing from another side. Conclusion: ①PVP is a mini-invasive , simple, quick and affirmatively effective proc