PKP治疗老年胸腰椎压缩骨折的疗效观察

摘要

Objective To study the effect of percutaneous kyphoplasty PKP (percutaneous) in the treatment of osteoporotic thoracolumbar vertebral compression fractures in elderly patients.Methods 83 patients with osteoporotic thoracolumbar compression fractures from our hospital from January 2014 to January 2015 were divided PKP group and conservative group.Conservative treatment was used in the conservative group,and the PKP group was treated with PKP operation.The vertebral height,Cobb angle,VAS score,ODI index,SF-36 quality of life score and functional recovery rate,1 year follow up rate of complications were observed.Results The good functional recovery rate of PKP group was higher than that of conservative group (P ＜ 0.05).The complications of 1 years of follow-up was similar in the two groups.There were no serious complications occurred.There was no vertebral compression fracture of adjacent vertebral fracture.At the time of discharge,the vertebral height,Cobb angle,VAS score,ODI index,SF-36 quality of life scores of PKP group were better than that of the conservative group.1 years after operation,the vertebral height,Cobb angle,VAS score,ODI index,SF 36 quality of life score of PKP group were better than that in the conservative group (P ＜ 0.05).Conclusion The treatment of osteoporotic thoracolumbar compression fractures using PKP can effectively relieve the pain of patients,promote the recovery of vertebral height and Cobb angle,improve lumbar function and the quality of life.%目的 探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松性胸腰椎压缩骨折的临床效果.方法 选取西藏成办医院和华西医院2014年1月～2015年1月收治的老年骨质疏松性胸腰椎压缩骨折患者83例,根据单双数编号法,分为PKP组和保守组.保守组采用保守治疗;PKP组采用PKP手术治疗.对两组患者出院时和术后1年椎体高度、Cobb角、VAS评分、ODI指数、SF-36生活质量评分和功能恢复优良率及随访1年并发症的发生率进行比较.结果 ①PKP组与保守组比较,功能恢复优良率更高(P＜0.05);随访1年并发症发生率两组相似,均无严重并发症发生,均未出现压缩性骨折椎体邻近椎体骨折,PKP组仅有2例骨水泥渗漏(P＞0.05);②出院时,PKP组患者椎体高度、Cobb角、VAS评分、ODI指数、SF-36生活质量评分均优于保守组(P＜0.05);术后1年两组患者椎体高度、Cobb角、VAS评分、ODI指数、SF-36生活质量评分均有改善,而PKP组上述指标均优于保守组(P＜0.05).结论 PKP治疗老年骨质疏松性胸腰椎压缩骨折临床效果确切,可有效缓解患者疼痛,促进椎体高度和Cobb角的恢复及腰椎功能和生活质量的改善,手术安全性高,无压缩性骨折椎体邻近椎体骨折风险,可在临床推广应用.