经皮椎体成形术／后凸成形术结合体位复位治疗骨质疏松性椎体压缩性骨折

摘要

目的：探讨经皮椎体成形术/经皮球囊扩张后凸成形术治疗骨质疏松性椎体压缩性骨折的手术效果。方法采用经皮椎体成形术（PVP）/经皮球囊扩张后凸成形术（PKP）治疗骨质疏松性椎体压缩性骨折41例，其中PVP32例，PKP9例，测量术前、术后3 d、术后3月的椎体前缘高度百分比（伤椎前缘高度/上下椎体前缘高度平均值）×100％和Cobb角；术前和术后3 d、术后3月对患者进行VAS和ODI评分。结果41例患者均获随访，随访时间3～24月，中位随访时间10．3月。患者术前Cobb角为（21．9±7．1）o，术后3 d为（5．9±2．7）o，术后3月（5．7±2．7）o。术前伤椎前缘高度比为55．5％±15．0％，术后3 d为82．9％±8．7％，术后3月为79．5％±8．6％。术前VAS评分为8．53±0．56，术后3 d为1．65±0．17，术后3月为1．40±0．15。术前ODI评分为33．08±4．72，术后3 d为10．05±1．65，术后3月为10．64±1．68。术前、术后的Cobb角、椎体前缘高度百分比、VAS和ODI评分差别均有统计学意义（P＜0．05）。结论经皮椎体成形术/后凸成形术结合体位复位具有能部分恢复椎体高度、止痛和脊椎功能恢复满意的功能。%Objective To assess the affects of percutaneous vertebroplasty (PVP)or percutaneous kyphoplasty(PKP)in the treatment ofosteoporotic vertebral compression fractures.Methods The study reviewed 41 patients of osteoporotic thoracolumbar compression frac-tures without spinal cord injury from July 2011 to July 2013 in our hospital.The patients were divided into two groups,with 32 cases trea-ted with PVP and 9 cases treated with PKP.measure fanterior flange height percentage (injured vertebral frontal height/fluctuation fanteri-or flange height average) ×100 % in preoperative and postoperative 3 days,postoperative 3 months and Cobb’s Angle;VSA for pain andOswestry disability index (ODI)questionnaire scores were assessed before treatment and at the third day,3months after treatment.Results The follow-up time ranged from 3 to 24 months,mean 10.3 months.the value of Cobb’s Angle before surgery is (21.9 ±7.1)°,and at3 days after operation is (5.9 ±2.7)°,and at 3 months after operation is (5.7 ±2.7)°.fanterior flange height percentage before surgeryis 55.5 ±15.0%,and at 3 days after operation is 82.9 ±8.7%,and at 3 months after operation is 79.5 ±8.6%.the VAS score beforesurgery is 8.53 ±0.56,and at 3 days after operation is 1.65 ±0.17,and at 3 months after operation is 1.40 ±0.15.the ODI score beforesurgery is 33.08 ±4.72,and at 3 days after operation is 10.05 ±1.65,and at 3 months after operation is 10.64 ±1.68.There is a statisti-cal difference between before and after operation (P <0.05).Conclusions Both PVP and PKP are effective for restore vertebral bodyheight,the pain relief and the function improvement of osteoporotic vertebral compression fractures.