摘要
目的探讨球囊二次扩张椎体后凸成形术治疗老年重度骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法将60例重度OVCF患者随机分为球囊二次扩张组和球囊单次扩张组,每组30例。球囊二次扩张组行单侧穿刺球囊二次扩张椎体后凸成形术治疗,球囊单次扩张组行单侧经皮穿刺球囊扩张椎体后凸成形术治疗。术后3、6、12个月定期随访。记录手术时间、出血量、骨水泥注入量、骨水泥渗漏率,采用疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体前缘高度和椎体后凸Cobb角评价疗效。结果 2组手术时间、出血量、骨水泥渗漏率的差异无统计学意义(P>0.05),球囊二次扩张组骨水泥注入量较球囊单次扩张组多(P<0.05)。2组比较,术后1 d和术后3、6、12个月时VAS评分及ODI的差异无统计学意义(P>0.05),球囊二次扩张组的椎体前缘高度较球囊单次扩张组高(P<0.05),椎体后凸Cobb角较球囊单次扩张组小(P<0.05)。随访过程中球囊二次扩张组有2例非手术椎体再发骨折;球囊单次扩张组有5例非手术椎体再发骨折,1例出现神经脊髓症状。结论球囊二次扩张椎体后凸成形术治疗老年重度OVCF,能较好地恢复椎体高度,改善脊柱后凸角畸形,增加骨水泥注入量,减少骨水泥渗漏等并发症,是治疗重度OVCF的有效方法。
Objective To evaluate the efficacy of double-balloon dilation in percutaneous kyphoplasty for severe osteoporotic verte- bral compression fracture （OVCF） in the elderly. Methods Sixty patients with severe OVCF were randomly divided into two groups, a double- and a single-balloon dilatation group, with 30 cases in each group. Regular follow-up was conducted at 3,6, and 12 months after operation. The operation time, blood loss volume, bone cement injection rate, and bone cement leakage rate were recorded. The visual analog score （VAS）, Oswestry disability index （ODI）, vertebral anterior height, and kyphosis Cobb angle were used to evaluate effica- cy. Results No significant differences in operation time and bleeding volume were found between the 2 groups （P 〉 0.05）. The amount of bone cement injection in the double-balloon dilatation group was more than that in the single-balloon dilatation group （P 〈 0.05）. The bone cement leakage rate was lower in the double-balloon dilatation group, but the difference was not statistically significant （P 〉 0.05）. No significant differences in VAS score and ODI were found between the 2 groups at 1 day and 3,6,and 12 months after operation （P 〉 0.05）, but with significant differences in the anterior vertebral height and kyphosis Cobb angle （P 〈 0.05）. During the follow-up, 2 cases of complication occurred in the double-balloon dilatation group,but 6 cases of complication occurred in the single-balloon dilatation group. Conclusion Double-balloon dilation in percutaneous kyphoplasty for elderly patients with severe OVCF can effectively alleviate clinical symptoms and reduce complications, which is an effective method for the treatment of severe OVCF.
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2018年第1期27-31,35,共6页
Journal of China Medical University
基金
四川省科技厅支撑计划(2015SZ0190)
