椎體后凸成形術(shù)治療無(wú)神經(jīng)損傷的a3.1型骨質(zhì)疏松性胸腰椎爆裂性骨折

1、 椎體后凸成形術(shù)治療無(wú)神經(jīng)損傷的 A3.1 型骨質(zhì)疏松性胸腰椎爆裂性骨折 中文摘要 [目的 目的] 回顧性研究應(yīng)用椎體后凸成形術(shù) （Kyphoplasty,KP） 治療無(wú)神經(jīng)損傷的 A3.1 型骨質(zhì)疏松性胸腰椎爆裂性骨折，探討其可行性及其療效。 [方法 方法] 隨訪(fǎng)我科自 2007 年 1 月至 2010 年 10 月間應(yīng)用椎體后凸成形術(shù)治療無(wú)神經(jīng)損傷的 A3.1 型骨質(zhì)疏松性胸腰椎爆裂性骨折的病例， 對(duì)隨訪(fǎng)資料完整的 40 例病例進(jìn)

2、行療效分析。分別于術(shù)前、術(shù)后及末次隨訪(fǎng)時(shí)采用視覺(jué)模擬評(píng)分法（visual analogue scales,VAS） 、Oswestry 功能障礙指數(shù)（Oswestry Disability Indexes,ODI）評(píng)估患者疼痛和日常生活功能，并測(cè)量術(shù)前、術(shù)后及末次隨訪(fǎng)時(shí)骨折椎體前緣、中緣、后緣的高度，Cobb 角及椎管內(nèi)骨塊占位率。采用重復(fù)測(cè)量方差分析，比較術(shù)前、術(shù)后及末次隨訪(fǎng)時(shí)的數(shù)據(jù)。 [結(jié)果 結(jié)果] VAS 評(píng)分由術(shù)前 8.2

3、77;0.9 降至術(shù)后 3.0±0.8， 末次隨訪(fǎng)時(shí) VAS 評(píng)分為 3.2±0.7。 ODI評(píng)分由術(shù)前 71.7%±8.8%降至術(shù)后 35.1%±5.5%， 末次隨訪(fǎng)時(shí) ODI 評(píng)分為 36.0%±4.8%。椎體前緣高度術(shù)前、術(shù)后、末次隨訪(fǎng)時(shí)分別為 63.1%±14.9%，79.4%±13.0%，78.0%±13.4%，椎體中緣高度術(shù)前、術(shù)后、末次隨訪(fǎng)時(shí)分

4、別為 58.0%±15.2%，79.0%±11.2%，78.7%±11.5%，椎體后緣高度術(shù)前、術(shù)后、末次隨訪(fǎng)時(shí)分別為86.4%±7.2%，91.9%±6.1%，90.1%±8.4%。Cobb 角由術(shù)前 16.4°±9.7°下降至術(shù)后11.6°±7.4°，末次隨訪(fǎng)時(shí)為 12.6°±9.0°

5、。椎管內(nèi)骨塊占位率術(shù)前、術(shù)后及末次隨訪(fǎng)時(shí)分別為 26.3%±5.0%，26.0%±5.0%，19.6%±4.5%。 各項(xiàng)指標(biāo)（VAS、ODI、椎體前、中、后緣高度，Cobb 角）術(shù)前與術(shù)后及術(shù)前與末次隨訪(fǎng)差異均有統(tǒng)計(jì)學(xué)意義（P0.05） 。椎管內(nèi)骨塊占位率術(shù)前與術(shù)后差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05） ，術(shù)前與末次III Kyphoplasty for the treatment of type-A3.1

6、 painful osteoprotic thoracolumbar burst fractures without neurologic deficit Abstract [Objective] To explore the feasibility and clinical outcome of using kyphoplasty for the treatment of type-A3.1 painful osteoporotic

7、thoracolumbar burst fracture without neurological deficit. [Methods] From January 2007 until October 2010, forty patients with type-A3.1 painful osteoporotic thoracolumbar burst fracture without neurological deficit und

8、erwent kyphoplasty. Pain was measured using self-reporting visual analogue scale(VAS) preoperatively, postoperatively and at the last follow-up. Disability was measured using the Oswestry Disability Indexes(ODI) preopera

9、tively, postoperatively and at the last follow-up. The anterior, central, posterior heights of the compromised vertebral body, the kyphotic angle and the spinal canal compromise were measured preoperatively, postoperativ

10、ely and at the last follow-up.Comparisons of variance data between preoperatively, postoperatively and at the last follow-up were analysed by repeated measures analysis of variance. [Results] Mean VAS score decreased fro

11、m 8.2±0.9 preoperatively to 3.0±0.8 postoperatively (P<0.05),and was maintained at 3.2±0.7 at the last follow-up.The ODI score varied from 71.7%±8.8% preoperatively to 35.1%±5.5% postoperative

12、ly(P<0.05),and was maintained at 36.0%±4.8% at the last follow-up.Postoperatively,the height of anterior vertebrae was restored from 63.1%±14.9% to 79.4%±13.0%(P<0.05),the height of midline vertebrae