单球囊双侧扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的效果分析

目的：探讨单球囊双侧扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折的临床疗效。方法：选取择期在我院接受单球囊双侧扩张椎体后凸成形术治疗骨质疏松性椎体压缩骨折的52例老年患者的临床资料，对患者的疼痛评分、椎体高度变化情况、术前和术后的后凸cobb角改善情况、术后复发情况等进行分析。结果：全部患者术后随访2-17个月，疼痛均得到缓解，术前VAS评分为8．6，术后VAS评分为2．5，差异具有统计学意义（P〈0．05）；平均椎体前缘高度恢复（56．5％±34％），中部恢复（60．5％±35．4％），后缘恢复（40．7％±32-3％），矢状面排列改善明显（P〈0．05）；与术前相比，手术后患者侧位X片显示Cobb角平均改善10。（P〈0．05）。术后3例发生椎体前缘骨水泥渗漏，但未引起其他并发症；1例发生肋间神经痛，经保守治疗6个月后症状得到缓解。结论：单球囊zt-N扩张椎体后凸成形术治疗老年骨质疏松性椎体压缩骨折效果明显，值得临床推广。

Effects of Bilateral Transpedicular Kyphoplasty with Single Balloon on the Treatment of Osteoporotic Vertebral Compressed Fractures for Elder Patients

Objective： To investigate the clinical efficacy of bilateral transpedicular kyphoplasty with single balloon on the treat- ment of the osteoporotic vertebral compressed fractures in elder patients. Methods： 52 patients with osteoporotic vertebral compressed fractures who were treated by the percutaneous bilateral transpedicular kyphoplasty with single balloon were selected. Then the VAS of patients, the vertebral height restoration, the improvement of Cobb＇s angle after the operation and the postoperative recurrence of patients were analyzed. Results： All the patients were followed up for 2-17 months and experienced dramatic pain relief after the procedures. The average pain score （VAS） of patients decreased from 8.6 to 2.5 after the operation, and there was statistically significant difference（P〈0. 05）. The vertebral height restoration on the anterior border was （56.5%＋ 34%）, the middle portion was （60.5%＋ 35.4%）, and the posterior border was （40.7%~ 32.3%）. The improvement of sagittal alignment was significant（P〈0.05）. Comparing with the situation before opera- tion, the average correction of Cobb＇s angle has reached 10~ presented by the X-ray（P〈0.05）. There were three cases with no more clini- cal symptoms but less cement at the anterior vertebral edge after treatment. Another one with intercostal neuralgia got relief when treated by NSAIDs for six months. Conclusion： It is obvious that the bilateral transpedicular kyphoplasty with single balloon has the influence on the treatment of osteoporotic vertebral compressed fractures, and it is worthy of clinical promotion.