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【摘要】 ：［目的］ 探讨老年骨质疏松性椎体压缩骨折有效治疗途径。［方法］ 应用术前定位法开展PKP术，结合中医三期分治治疗老年骨质疏松性椎体压缩骨折。［结果］ 50例均一次穿刺成功，无临床并发症发生，42例患者术后疼痛完全缓解；8例患者术后腰部有酸胀感，于术后次日至第三日缓解。术后X线片复查提示椎体高度平均丢失约（7.3±2.7）mm，Cobb氏角矫正至平均(1.43±6.5)°，较术前恢复满意。［结论］ 应用术前定位法开展PKP术，结合中医三期分治治疗老年骨质疏松性椎体压缩骨折临床有效。
【关键词】 骨质疏松;经皮椎体后凸成形术;椎体压缩骨折
Abstract：［Objective］ To explore effective method for senile osteoporosis vertebral compression fracture.［Method］ Make PKP operation with preoperation orientation, combining with 3phase TCM therapy, for senile osteoporosis vertebral compression fracture.［Result］ 50 cases were successful with one puncture, without clinical complication; 42 cases were completely relieved of postoperation pain; 8 had sour and swelling sensation and were relieved 2 or 3 days later. The Xray recheck showed vertebral height was lost （7.3±2.7）mm in average, the Cobb angle was corrected to average (1.43±6.5)°，all more satisfying than preoperation.［Conclusion］ Applying preoperation orientation for PKP operation, combining with 3phase TCM therapy, is clinically effective for senile osteoporosis vertebral compression fracture.
Key words： osteoporosis; percutaneous kyphophlasty; vertebral compression fracture
经皮椎体后凸成形术(percutaneous kyphoplasty ,PKP)作为脊柱外科微创新技术，具有创伤小、并发症少、疼痛缓解迅速的优点，已经成为治疗老年骨质疏松性椎体压缩骨折(OVCF)的常用治疗手段。我院自2000年1月应用术前定位法开展PKP术，结合中医三期分治治疗老年骨质疏松性椎体压缩骨折50例，疗效显著，现总结报告如下。
1 临床资料
1.1 一般资料
本组50例均为老年OVCF。男19例，女31例。年龄50～85岁，平均67岁。外伤至手术时间3d～8d，平均5d。其中1个椎体压缩骨折36例，2个椎体压缩骨折12例，3个椎体压缩骨折2例，共66个椎体。累及节段T8椎体3个，T11椎体5个，T12椎体27个，L1椎体22个，L3椎体5个，L4椎体4个。取患椎相邻两正常椎体前缘高度的平均值为患椎的伤前原始高度，所有患椎高度平均丢失（16.2±3.9）mm，Cobb氏角（25.7±11.3）°。所有病例均在轻微外伤后出现持续性的胸腰背部疼痛，活动受限，生活不能自理，需卧床休息。但无神经系统损坏征象。
1.2 影像表现
本组50例，X 线摄片提示所见脊椎诸骨普遍骨质疏松，椎体压缩在10% ～75%之间。CT提示胸腰椎骨折椎体后缘完整，硬膜囊未受压。MRI表现胸腰椎骨折，T1加权像为低信号，T2加权像为高信号。
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