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目的探讨经皮椎体成形术(PV)联合抗骨质疏松药物治疗围绝经期女性骨质疏松性椎体压缩骨折(OVCF)的疗效。方法选取2012年4月-2015年3月吉林大学第二医院收治的87例围绝经期骨质疏松性OVCF患者为研究对象,所有患者均给予PV联合抗骨质疏松药物治疗,记录统计所有患者致伤因素,平均骨水泥用量,治疗前后压缩骨折椎体高度恢复率、Cobb角、ODI、VAS评分、术后不良反应及患者椎体骨折再发情况。结果 87例患者中,86例患者因跌倒引起OVCF,占98.9%,所有患者平均骨水泥用量为(3.8±1.5)ml。治疗前骨折椎体高度恢复率、Cobb角、ODI、VAS评分均明显高于治疗后1周、治疗后3个月(P<0.001)。术后有1例患者出现右下肢麻木、疼痛,后行CT检查显示神经根受泄露的骨水泥压迫,后行开放性手术将泄露的骨水泥取出后,患者右下肢麻木、疼痛消失。术后随访6个月,未发现有患者再次发生OVCF。结论围绝经期女性骨质疏松性OVCF在PV联合抗骨质疏松药物治疗后可快速缓解患者腰背部疼痛,改善腰椎活动度,矫正后凸畸形,恢复椎体高度,且发生并发症几率低。
Objective To investigate the effect of percutaneous vertebroplasty (PV) and anti-osteoporosis drugs on osteoporotic vertebral compression fractures (OVCF) in perimenopausal women. Methods A total of 87 patients with perimenopausal osteoporotic osteoporosis (OVCF) admitted to the Second Hospital of Jilin University from April 2012 to March 2015 were enrolled in this study. All patients were given PV combined with anti-osteoporosis drugs. All patients Injury factors, average amount of bone cement, vertebral body height recovery before and after compression fractures, Cobb angle, ODI, VAS score, postoperative adverse reactions and recurrence of vertebral fractures. RESULTS: Of the 87 patients, 86 resulted in OVCF due to falls, accounting for 98.9% of the patients, and averaged 3.8 ± 1.5 in all patients. The vertebral body height recovery rate, Cobb angle, ODI and VAS score before treatment were significantly higher than those after 1 week and 3 months after treatment (P <0.001). One patient had postoperative numbness and pain in his right lower extremity. Computed tomography showed nerve roots were exposed to leaked bone cement. After open surgery, the exposed bone cement was removed and the patient’s right lower extremity was numb and the pain disappeared. Postoperative follow-up of 6 months, no recurrence of patients with OVCF was found. Conclusion Perimenopausal women with osteoporotic OVCF after PV combined with anti-osteoporosis drugs can quickly relieve lumbar and back pain, improve lumbar mobility, correct kyphosis, and restore vertebral body height with low complication rate.