摘要
目的探讨经皮椎体成形术或经皮后凸椎体成形术治疗椎体压缩性骨折骨不连术后至少2年的随访的影像学及临床疗效评估。方法回顾分析2012-06-2013-12我院行PKP或PVP治疗并完成随访的44例椎体压缩性骨折骨不连患者。通过对患者后凸角(cobb角)、椎体前后缘高度比、疼痛视觉模拟量表(visual analogure scale,VAS)评分及功能障碍指数(Oswestry disability index,ODI)的变化评定手术疗效。结果随访24-35个月,平均28.3个月。经过椎体成形术后椎体的高度和后凸角度得到了很好的纠正。但是,通过长时间的随访发现恢复高度的椎体进行性的压缩(P<0.05)和后凸角度的再加重(P<0.05)。术后患者的VAS和ODI均得到了不同程度的降低。但是VAS和ODI在术后的2年均有增加。结论 NVF的患者椎体内存在真空、假关节、或椎体内的水征现象,椎体成形术可能不能提供足够的稳定性和长时间维持稳定。术后存在进行性的椎体压缩现象。因此,笔者强烈推荐对PKP或PVP手术后的病人应进行长期随访,观察PKP或PVP治疗NVF的更远期疗效。
Objective To assess the radiological and clinical outcomes of percutaneous vertebroplasty or percutaneous balloon kyphoplasty in the treatment of nonunion of vertebral compression fractures for at least 2 years. Methods 44 patients with nonunion of vertebral compression fractures in Xi＇an Honghui Hospital from June 2012 to December 2013 were selected. We based on anterior trailing edge height ratio, kyphotic angle, visual analogue scale （VAS） score and Oswestry disability index （ODI）, to evaluate the surgical curative effect. Results The patients were followed up for 24-35 months, average 28.3 months. The vertebral body height and Cobb angle was corrected significantly after PKP/PVP. However, the restored vertebral height recollapsed （P〈0.05）, and the kyphotic angle became aggravated （P〈0.05） during the 2 years or longer of postoperative follow-up. Compared with preoperation, all patients had good VAS and ODI postoperation. But the VAS and ODI at postoperative 2 years increased. Conclusion We should observe the long-term curative effect for patients with nonunion of vertebral compression fractures who accepted PKP and PVP.
出处
《颈腰痛杂志》
2017年第1期47-50,共4页
The Journal of Cervicodynia and Lumbodynia
