摘要
目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)和骨囊袋填充椎体成形术(vesselplasty)治疗骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效。方法对2016年9月至2016年12月,我院收治的68例OVCF患者进行回顾性分析,其中采用PKP治疗34例(PKP组),男13例,女21例;年龄52~88岁,平均(67.21±5.79)岁。采用vesselplasty治疗34例(Vesselplasty组),男11例,女23例;年龄53~89岁,平均(68.06±5.22)岁。术后3天、1个月及末次随访采用疼痛视觉模拟评分(visual analogue scale,VAS)、Oswestry功能障碍指数(oswestry disability index,ODI)对术后患者疼痛缓解程度及日常生活功能的改善情况进行评定;通过影像学资料观察责任椎前缘和中部相对高度、责任椎Cobb’s角的变化。结果术后PKP组骨水泥渗漏8例,Vesselplasty组骨水泥渗漏1例。所有患者均获得3个月以上的随访。Vesselplasty组平均手术时间为(31.65±3.06)min,PKP组为(37.97±5.41)min,差异有统计学意义(P<0.05)。Vesselplasty组平均透视次数为10.71±1.87,PKP组为14.32±2.52,差异有统计学意义(P<0.05)。VAS评分:Vesselplasty组术前(8.12±0.73)分,术后3天(2.82±1.31)分;PKP组术前(8.03±0.87)分,术后3天(2.74±1.42)分。ODI评分:Vesselplasty组术前(82.79±3.34)分,术后3天(29.18±5.46)分;PKP组术前(82.44±3.58)分,术后3天(28.74±5.33)分。两组VAS和ODI评分术后较术前均有明显改善,差异有统计学意义(P<0.01)。两组术后椎体前缘相对高度:Vesselplasty组术前63.32±4.26,术后3天79.21±3.41;PKP组术前62.76±4.06,术后3天78.09±3.90。中部相对高度:Vesselplasty组术前67.12±4.31,术后3天83.35±3.47;PKP组术前66.81±4.57,术后3天81.82±3.93。责任椎Cobb’s角:Vesselplasty组术前(18.94±3.22)°,术后3天(9.98±2.14)°;PKP组术前(19.26±2.80)°,术后3天(10.76±2.37)°。均有明显恢复,差异有统计学意义(P<0.01)。两组间比较,Vesselplasty组术后椎体前缘相对高度
Objective To observe the clinical outcomes of percutanous kyphoplasty（ PKP） and vesselplasty for osteoporotic vertebral compression fractures（ OVCF）. Methods From September 2016 to December 2016, the data of 68 patients with OVCF were retrospectively analyzed. Among them, 34 patients were treated with PKP（ PKP Group, 13 males and 21 females）, with an average age of（ 67.21 ± 5.79） years（ range： 52-88 years）; 34 patients were treated with vesselplasty（ Vesselplasty Group, 11 males and 23 females）, with an average of（ 68.06 ± 5.22） years（ range： 53-89 years）. Three days postoperatively, 1 month postoperatively, in the latest follow-up, pain and daily life functions were respectively assessed by visual analogue scale（ VAS） and Oswestry index（ ODI）; the height of the responsible vertebra, Cobb＇s angle were measured by X-rays. Results Eight cases complicated with bone cement leakage in PKP Group, while 1 in Vesselplasty Group. All patients were followed up for more than 3 months. The mean operation time was（ 31.65 ± 3.06） min in Vesselplasty Group, and（ 37.97 ± 5.41） min in PKP Group, with significant differences（ P 0.05）. The mean number of times of intraoperative fluoroscopy was（ 10.71 ± 1.87） in Vesselplasty Group, and（ 14.32 ± 2.52） in PKP Group, with significant differences（ P 0.05）. Compared with preoperative index, postoperative VAS score（ Vesselplasty Group： 8.12 ± 0.73 preoperatively vs. 2.82 ± 1.31 3 days postoperatively; PKP Group： 8.03 ± 0.87 preoperatively vs. 2.74 ± 1.42 3 days postoperatively） and ODI score（ Vesselplasty Group： 82.79 ± 3.34 preoperatively vs. 29.18 ± 5.46 3 days postoperatively; PKP Group： 82.44 ± 3.58 preoperatively vs. 28.74 ± 5.33 3 days postoperatively） within two groups were greatly improved with significant differences（ P 0.01）. Compared with preoperative indexes, anterior height of the responsible vertebra（ Vesselplasty Group： 63.32 ± 4.26 preoperatively vs. 79.21 ± 3.41 3
出处
《中国骨与关节杂志》
CAS
2018年第2期120-126,共7页
Chinese Journal of Bone and Joint
