椎体成形术治疗老年骨质疏松脊柱骨折的临床研究

摘要

Objective To evaluate the efficacy and complications of different surgical of vertebroplasty in the treatment of osteoporotic vertebral fracture in the elderly. Methods One hundred patients diagnosed as osteoporotic spinal fractures were equally and randomly divided into the PVP groups and the PKP group. Patients in the PKP group were treat with percutaneous kyphoplasty (PKP), while that in the PVP groupws were treated with simple percutaneous vertebroplasty (PVP). The clinical efficacy, improvement in radiographic parameters and complications were compared between the two groups. Results The VAS score and Oswestry score were decreased after operation in both groups (P<0.05), and the decrease of postoperative VAS scores and Oswestry score in the PKP group was more pronounced (P<0.05). The vertebral kyphosis angle, front height, middle height and posterior height in the PKP group increased after treatment (P <0.05), while those in the PVP group show no statistically significant difference after treatment (P> 0.05). The leakage incidence of the PKP group (2%) was lower than that in the PVP group (20%, P＜0.05). Conclusion PKP and PVP are effective for the treatment of osteoporotic spinal fractures. PVP costs less, while PKP is superior in the improvement of symptoms, quality of life in patients, and complications, as well as the restoration of vertebral body shape.%目的 探讨不同术式的椎体成形术治疗老年骨质疏松脊柱骨折的临床疗效和并发症发生情况。方法 100例确诊为老年骨质疏松脊柱骨折的患者平均、随机分为PKP组和PVP组，PKP组行经皮椎体后凸成形术(PKP)，PVP组行单纯经皮椎体成形术(PVP)，比较两组临床疗效、影像学指标改善情况和并发症情况。结果 PKP组和PVP组术后VAS评分、Oswestry评分均较术前下降(P＜0.05)，PKPS组术后VAS评分、Oswestry评分下降幅度大于PVP组(P＜0.05)。PKP组治疗后椎体后凸角、前缘高度、中线高度及后缘高度均较治疗前提高（P＜0.05），PVP组治疗后以上影像学指标均与治疗前差异无统计学意义(p＞0.05)。渗漏发生率PKP组(2％)低于PVP组(20％，P＜0.05)。结论 PKP、PVP均为治疗老年骨质疏松脊柱骨折的有效手段，PVP费用较低，PKP能更好改善症状和提高日常生活能力，恢复椎体形态，减少并发症发生。