目的 回顾性分析前期111例PVP/PKP术治疗胸腰椎老年骨质疏松性骨折患者临床资料,探讨PVP、PKP手术疗效及相关问题.方法 回顾性分析我院2007年～2010年期间运用PVP、PKP治疗111例椎体压缩性骨折患者,术后随访3～24个月,平均13.7±7.09个月,采用VAS疼痛评分、镇痛药使用评分、Oswestry功能障碍指数临床疗效评定,Cobb角测量椎体形态评价术后椎体再压缩及相邻近椎体压缩情况,设计量表观察PVP与PKP、单侧进针与双侧进针、骨水泥量、俯卧与侧卧的治疗效果及渗漏情况.结果 经统计分析发现,PVP与PKP、单侧进针及双侧进针、不同骨水泥用量、俯卧与侧卧治疗椎体压缩性骨折的临床疗效无统计学差异,PVP与PKP对渗漏影响有统计学差异；并发现三例患者术后发生邻近椎体再骨折.结论 无论采取PVP、PKP,单、双侧进针,俯卧与侧卧的手术方式,运用一定量骨水泥,均能有效缓解椎体压缩性骨折的椎体疼痛；另外PKP相比PVP能较为有效防止骨水泥渗漏.%Objective To analyze retrospectively the early stage clinical data of 111 elderly thoracolumbar fracture patients treated with PVP/PKP and to explore the surgical effects of PVP and PKP and the related issues. Methods One hundred and eleven elderly thoracolumbar fracture patients treated with PVP/PKP from 2007 to 2010 in our hospital were retrospectively analyzed. The follow-up time after the surgery was 3 to 24 months, 13.7 ±7.09 months in average. The clinical effects were evaluated using VAS pain score, analgesic use score, and Oswestry disability index of function. The post operation vertebral recompression condition and the compression of adjacent vertebra were evaluated using Cobb angle measuring for the vertebral shape. The questionnaire was designed to observe the effects of PVP and PKP, unilateral or bilateral needling, amount of bone cement, prone or lateral position, and the leakage. Results Statistical analysis revealed that there was no significant difference between PVP and PKP, unilateral and bilateral needling, different amount of bone cement, and prone and lateral position. The difference of leakage effect between PVP and PKP was statistically significant. Adjacent vertebral re-fracture occurred in 3 patients. Conclusion No matter the use of PVP or PKP, single or bilateral needling, prone or lateral surgical position, the vertebral pain after vertebral compression fracture can be effectively alleviated using a certain amount of bone cement. In addition, PKP is more effective in preventing cement leakage than PVP.
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