单侧穿刺经皮椎体后凸成形术联合药物治疗老年骨质疏松性椎体压缩骨折的临床疗效

摘要

目的 观察单侧穿刺经皮椎体后凸成形术(PKP)联合抗骨质疏松药物治疗老年骨质疏松性椎体压缩骨折(CFVO)病人的临床疗效.方法 将我院2014年6月至2016年6月收治的86例老年CFVO病人随机分为对照组(42例)和观察组(44例),2组骨折病人均行单侧穿刺PKP,观察组术后额外给予唑来膦酸注射液5 mg静脉滴注抗骨质疏松治疗,通过分析治疗前和治疗后3 d、1月、6月病人视觉模拟评分法(VAS)疼痛评分,伤椎高度和Cobb角变化及骨密度来观察临床疗效.病人均进行了6~9月临床随访.结果 2组治疗后的VAS评分、伤椎高度和Cobb角均较治疗前有显著改善(P<0.05).治疗后6月观察组骨密度改善较对照组更显著(P<0.05).结论 单侧PKP联合抗骨质疏松药物治疗老年CFVO,可明显缓解病人疼痛,改善病人骨密度,并能减少相邻椎体再骨折,近期及中期的疗效确切.%Objective To observe the clinical efficacy of unilateral puncture percutaneous kyphoplasty ( PKP ) combined with anti-osteoporosis drugs in the treatment of compression fracture of vertebra due to osteoporosis( CFVO) in elderly patients. Methods From June 2014 to June 2016, 86 elderly patients with CFVO in our hospital were enrolled and randomly divided into observation group (n=42) and control group ( n=44). The control group received unilateral puncture PKP, and the observation group received unilateral puncture PKP and 5 mg zoledronic acid by intravenous drip monthly was conducted after operation. The score of visual analogue scale (VAS), height of damaged vertebra ( HDV) , transforming of Cobb angle ( TCA) as well as bone density( BD) were recorded before or 3 d, 1 month and 6 months after operation. All patients were followed up for 6-9 months. Results The levels of VAS, HDV, TCA were significantly improved after PKP in two groups (P<0. 05). Compared with control group, a significant increase of BD was observed in observation group ( P<0. 05) . Conclusions Unilateral PKP combined with anti-osteoporosis drug in the treatment of elderly patients with CFVO is an effective method to relieve pain, increase bone density and prevent the second facture of adjacent vertebral.