摘要
[目的]比较椎体成形术(PVP)后邻近椎体新发骨折保守治疗与再次PVP的疗效。[方法]回顾性研究2015年8月~2018年8月在本院骨科因骨质疏松性椎体压缩骨折行PVP术后95例邻近椎体新发骨折的患者,采用保守治疗32例,PVP再手术63例,采用VAS和ODI评分评价临床效果,拍摄X线片,测量局部后凸Cobb角和椎体前缘压缩比。[结果]随时间推移,两组患者的VAS评分及ODI指数均显著降低(P<0.05)。治疗前两组患者间VAS和ODI评分的差异均无统计学意义(P>0.05);治疗后1周和1个月时,手术组的VAS和ODI评分均显著低于保守组,差异有统计学意义(P<0.05);治疗后3、6个月时,手术组的VAS和ODI评分仍均低于保守组,但差异已无统计学意义(P>0.05)。保守组患者治疗前后局部后凸Cobb角和椎体前缘压缩率无显著变化(P>0.05);手术组术后各时间点局部后凸Cobb角和椎体前缘压缩率均较术前显著减少,差异有统计学(P<0.05)。治疗前两组间局部后凸Cobb角和椎体前缘压缩率的差异均无统计学意义(P>0.05),而治疗后各时间点,手术组的局部后凸Cobb角和椎体前缘压缩率均显著小于保守组(P<0.05)。[结论]与保守治疗相比,再次PVP手术治疗可更有效、迅速恢复经皮椎体成形术后邻近椎体新发骨折患者自主生活能力,并能够一定程度纠正脊柱后凸畸形,恢复脊柱力线。
[Objective] To compare the clinical outcomes of conservative therapy versus percutaneous vertebroplasty(PVP)again for the new-onset adjacent vertebral fractures after primary vertebroplasty on osteoporotic vertebral compression fractures(OVCF). [Methods] A retrospective study was conducted on 95 patients with the adjacent new-onset vertebral fractures after PVP for OVCF. In term of therapy applied, 32 patients received the conservative therapy, while the remaining 63 patients underwent PVP again. The visual analogue scale(VAS) for pain and Oswestry disability index(ODI) were used for evaluation of the clinical consequences. In addition, radiographs were taken to measure the local kyphotic Cobb’s angle and anterior vertebral compression ratio. [Results] As time went after treatments, the VAS and ODI scores in both groups significantly decreased(P<0.05). Although no statistically significant differences were found between the two group regarding the scores before treatments(P>0.05), the PVP group had lower VAS and ODI scores than the conservative group, which proved statistically significant at 1 week and 1 month(P<0.05), whereas statistically insignificant at 3 and 6 months(P>0.05). In term of radiographic assessment,the conservation group kept unchanged significantly in the local kyphotic Cobb’s angle and anterior vertebral compression ratio(P>0.05), whereas the PVP group got significant diminutions in the aforesaid radiographic parameters at all time points after operation compared with those before operation(P<0.05). The PVP group had significantly less local kyphotic Cobb’s angle and anterior vertebral compression ratio than the conservative group at all time points after treatment(P<0.05), regardless of no statistically significant differences between them before treatment(P>0.05). [Conclusion] The PVP again takes advantages of more effective and rapid recovery of patients’ ability, as well as correcting kyphotic deformity and restoring the vertebral alignment in some extent over the conservative ther
作者
曾庆虎
彭成忠
吴财
王乐乐
廖涛
曾钊
张勇军
ZENG Qing-hu;PENG Cheng-zhong;WU Cai;WANG Le-le;LIAO Tao;ZENG Zhao;ZHANG Yong-jun(Depart ment of Orthopaedics,Xiangdong Hospital Affiliated to Hunan Normal University,Zhuzhou 412200,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2019年第22期2022-2027,共6页
Orthopedic Journal of China
基金
湖南省教育厅一般基金项目(编号：12C0207)
