通过我们近千例的临床验证，急性和亚急性椎体压缩骨折骨水泥疗效立杆见影，目前PVP和PKP已在临床大规模开展。但对于慢性椎体压缩性骨折的骨水泥治疗的疗效尚不确定，近几年我们探索了一批骨折病史超过3个月的病例，仍有临床症状，包括疼痛、活动障碍等。初步的研究结论是肯定的。上海市第六人民医院介入影像科吴春根

　　附已发表论文摘要：

　　经皮椎体成形术治疗慢性症状性椎体压缩骨折的临床应用

　　王涛 吴春根 程永德 顾一峰朱雪娥 王珏 王武

　　作者单位：200233上海交通大学附属第六人民医院放射科

　　通讯作者：吴春根

　　【摘要】: 目的:对伤后3月以上的骨质疏松性椎体压缩性骨折患者行经皮椎体成形术( PVP),观察患者症状改善及并发症的发生。方法:对2006年5月至2008年5月间行PVP术的22例患者进行随访,根据MRI表现分为骨髓水肿组（组I）和无骨髓水肿组（组II），手术前后给予视觉模拟评分(VAS),比较不同骨折时间的VAS变化的差异,了解并发症的发生及患者的主观满意度。结果:平均随访时间12.2月，术前VAS评分组I为7.77±0.73、组II为7.44±0.88、总体为7.63±0.79，术后1天VAS评分组I为3.61±0.51、组II为3.88±0.60、总体为3.72±0.55，随访时VAS评分组I为3.46±1.05、组II为3.56±0.73、总体为3.50±0.91，所有患者无骨水泥渗漏造成的神经压迫等并发症;手术的主观满意度良好（约90.9%）。结论: 对于慢性症状性骨质疏松性椎体压缩骨折患者，PVP是一种有效、安全的治疗方法;MRI对于患者的评估非常重要,术前MRI出现骨髓水肿信号的患者疗效更显著。

　　【关键词】：经皮椎体成形术；骨质疏松；慢性椎体压缩骨折

　　Clinical application of percutaneous vertebroplasty in treatment chronic symptomatic osteoporotic vertebral compressive fractures  WANG Tao, WU Chun-gen, CHENG Yong-de, GU Yi-feng, ZHU Xue-e, WANG Jue, WANG Wu, Department of Radiology, The Affiliated Sixth People’s Hospital, Shanghai Jiao Tong University, Shanghai 200233,China

　　【Abstract】: Objective: Percutaneous vertebroplasty (PVP) was performed in patients of osteoporotic vertebral compression fractures which were injured for 3 months or more, symptom and complications has been observed in these patients. Methods: 22 cases who treated with PVP from May 2006 to May 2008, has been divided into two groups according to their MRI. One group has bone marrow edema(Group I), another without bone marrow edema (Group II). Visual analogue score(VAS) has been given before and after surgery. Compare difference of VAS on different fracture time to understand the complications and the patient"s subjective satisfaction. Results: The average follow-up period was 12.2 months, the preoperative VAS score Group I to 7.77 ± 0.73, Group II was 7.44 ± 0.88, in general was7.63 ± 0.79, after 1 day of surgery  VAS score of Group I was 3.61 ± 0.51, Group II was 3.88 ± 0.60, in general was 3.72 ± 0.55, follow-up VAS score Group I was 3.46 ± 1.05, Group II was 3.56 ± 0.73, in general was 3.50 ± 0.91. Complications such as nerve compression because of bone cement leakage didn’t appeared in all patients; Subjective satisfaction of Surgery in these patient was good (about 90.9%). Conclusion: For patients with chronic osteoporotic vertebral compressive fracture, PVP is a safe and effective treatment; MRI is very important for assessment, and those patients with  MRI signals of bone marrow edema before operative have more pronounced effect.
【Key words】: Percutaneous vertebroplasty; osteoporosis; chronic vertebral compressive fractures