摘要
目的观察经皮椎体后凸成形术(PKP)治疗骨质疏松性椎体压缩骨折(OVCF)的临床效果。方法回顾性分析126例OVCF患者的临床资料,将采用PKP治疗的69例患者纳入PKP组,将采用经皮椎体成形术(PVP)治疗的57例患者纳入PVP组。观察2组的手术情况和术后并发症发生情况,并比较2组伤椎矫治情况(伤椎前缘高度、椎体压缩率、Cobb角)及不同时点的疼痛程度[视觉模拟评分法(VAS)评分]、椎体功能[Oswestry功能障碍指数(ODI)评分]变化。结果PKP组手术时间长于PVP组,透视次数及骨水泥用量多于PVP组,差异有统计学意义(P<0.05);2组出血量比较,差异无统计学意义(P>0.05)。术后6个月时,2组伤椎前缘高度均大于术前,且PKP组大于PVP组,差异有统计学意义(P<0.05);2组椎体压缩率、Cobb角低于术前,且PKP组低于PVP组,差异有统计学意义(P<0.05)。术后,2组VAS评分均逐渐降低,组内差异有统计学意义(P<0.05);术前、术后3 d时,2组间VAS评分比较,差异无统计学意义(P>0.05);术后6个月时,PKP组VAS评分低于PVP组,差异有统计学意义(P<0.05)。术后,2组ODI评分均逐渐降低,组内差异有统计学意义(P<0.05);术前、术后1周及术后6个月时,2组间ODI评分比较,差异均无统计学意义(P>0.05)。PKP组总并发症发生率低于PVP组,差异有统计学意义(P<0.05)。结论PKP与PVP在改善OVCF患者椎体功能方面效果相当,PVP手术时间更短、术中透视次数更少,而PKP在矫治伤椎畸形、缓解疼痛和提升治疗安全性方面更具优势。
Objective To observe the clinical effects of percutaneous kyphoplasty(PKP)in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods The clinical data of 126 patients with OVCF was retrospectively analyzed.Sixty-nine patients treated with PKP were included in the PKP group,and 57 patients treated with percutaneous vertebroplasty(PVP)were included in the PVP group.The operative situation and postoperative complications of the two groups were observed,and the changes of the injured vertebral correction(anterior edge height,vertebral compression rate,Cobb angle),pain degree[Visual Analogue Scale(VAS)score]and vertebral function[Oswestry Disability Index(ODI)score]of the two groups were compared.Results The operative time in the PKP group was shorter,fluoroscopy frequency and bone cement amount were greater than those in the PVP group(P<0.05).There was no significant difference in bleeding amount between the two groups(P>0.05).At 6 months after operation,the anterior height of injured vertebrae in the two groups was increased compared with that before operation,and the height in the PKP group was larger than that in PVP group(P<0.05).The vertebral compression rates were lower and Cobb angles were smaller in the two groups than those before operation,and the above indexes in the PKP group were lower than those in the PVP group(P<0.05).After surgery,VAS scores in both groups gradually decreased,and the intra-group difference was statistically significant(P<0.05).VAS scores before surgery and 3 days after surgery between the two groups showed no significant differences(P>0.05).At 6 months after surgery,VAS score in the PKP group was significantly lower than that in the PVP group(P<0.05).After operation,ODI scores in both groups gradually decreased,and the intra-group difference was statistically significant(P<0.05).There were no significant differences in ODI scores between the two groups before surgery,1 week and 6 months after surgery(P>0.05).The total incidence rate of complications in the PKP gro
作者
孙义军
孙晴
龚福太
SUN Yijun;SUN Qing;GONG Futai(Spine Ward in Department of Orthopedics,Xi′an City Hospital of Traditional Chinese Medicine in Shaanxi Province,Xi′an,Shaanxi,710021)
出处
《实用临床医药杂志》
CAS
2020年第23期45-48,共4页
Journal of Clinical Medicine in Practice
基金
陕西省科技厅基金项目(2016JM02155)。
关键词
骨质疏松
椎体压缩骨折
经皮椎体后凸成形术
经皮椎体成形术
椎体功能
osteoporosis
vertebral compression fractures
percutaneous kyphoplasty
percutaneous vertebroplasty
vertebral body function
