经皮椎体成形术治疗不伴神经症状骨质疏松性椎体爆裂骨折的临床观察

摘要

目的 探讨经皮椎体成形术(PVP)治疗不伴神经症状的骨质疏松性椎体爆裂骨折的临床疗效和安全性.方法 回顾性分析2011年2月至2014年12月我院收治的100例单节段骨质疏松性椎体爆裂骨折患者的临床资料;按照治疗方法分为PVP组(经皮椎体成形术)和PKP组(经皮椎体后凸成形术).对比两组手术时间、骨水泥注入量、住院时间、住院花费及骨水泥渗漏等并发症;对比两组术前、术后及随访结束时的疼痛视觉模拟评分(VAS)、Oswestry功能障碍指数(ODI)、椎体高度(前缘、中央)、后凸Cobb角、椎管占位程度及生活质量SF-36评分.结果 两组术后及末次随访时的VAS、ODI、椎体高度、后凸Cobb角、椎管占位程度及SF-36评分均较术前明显改善,PKP在椎体高度、后凸Cobb角、椎管占位程度改善方面明显优于PKP组,差异具有统计学意义(P<0.05).结论 采用PVP和PKP治疗椎管占位<20%且无神经症状的不伴神经症状的骨质疏松性椎体爆裂骨折安全可行,二者各有优势,可根据具体情况选择.%Objective To investigate the clinical efficacy and safety of percutaneous vertebral angioplasty (PVP) in the treatment of osteoporotic vertebral burst fractures without neurological symptoms.Method Retrospective analysis from February 2011 to December 2014 in our hospital from 100 cases of single segment osteoporotic vertebral burst fractures in patients with clinical data, according to the method of treatment points for PVP (percutaneous balloon angioplasty) and PKP group (by percutaneous vertebroplasty and kyphoplasty). Comparison of two groups of operation time, amount of bone cement injection, duration of hospitalization, hospitalization cost and bone cement leakage complications such as;compared two groups of patients before surgery and followed up at the end of pain on a visual analogue scale (VAS), Oswestry disability index (ODI), vertebral height (anterior, central), after Cobb angle, vertebral canal accounted for level and quality of life of SF-36 scores.Result After two groups of surgery and at the final follow-up VAS, ODI, height of vertebral body, after Cobb angle, vertebral canal accounted for degree and SF-36 scores were compared with the preoperative significantly improved PKP in vertebral height, after Cobb angle, vertebral canal for the degree of improvement is better than PKP group, the difference has statistical significance (P<0.05).Conclusion Using PVP and PKP in the treatment of spinal canal occupying less than 20% and no neurological symptoms without neurological symptoms of osteoporotic vertebral burst fractures is safe and feasible, they both have advantage, can choose according to the specific circumstances.