椎体成形术治疗老年骨质疏松性脊柱骨折的临床研究

Clinical Study of Vertebroplasty in the Treatment of Elderly Osteoporotic Spinal Fracture

目的:研究椎体成形术治疗老年骨质疏松性脊柱骨折的疗效。方法:选择2012年1月至2014年1月我院收治的120例老年骨质疏松性脊柱骨折患者,均使用Sky骨扩张系统经皮穿刺行椎体成型术治疗,74例患者取俯卧位设为俯卧位组,46例患者取侧卧位设为侧卧位组,比较两组患者术前及术后3 d、3个月时椎体高度、后凸畸形角(Cobb角)及视觉疼痛模拟评分(VAS评分)。结果:术前两组患者椎体高度比较差异具有统计学意义(F=4.231,P=0.042),术后3d及3个月两组患者椎体高度较术前明显增高,比较差异具有统计学意义(F=4.03,P=0.047)。术前两组患者Cobb角变化比较差异无统计学意义(F=3.042,P=0.072),术后3 d及3个月两组患者Cobb角均值较术前明显降低,比较差异具有统计学意义(F=9.86,P=0.021)。术前两组患者VAS评分比较差异无统计学意义(F=2.035,P=0.089),术后3 d及3个月两组患者VAS评分较术前明显降低,比较差异具有统计学意义(F=12.86,P=0.005)。结论:使用椎体成形术治疗老年骨质疏松性脊柱骨折疗效显著,可有效恢复椎体高度及Cobb角度,并可迅速缓解其疼痛症状。

Objective： To study the efficacy of vertebroplasty in the treatment of elderly osteoporotic spinal fracture. Methods： A total of 120 elderly patients with senile osteoporotic spinal fracture were selected, who were admitted to West China Hospital of Sichuan University from January 2012 to January 2014, and treated by vertebroplasty with the Sky bone expander system through percutaneous puncture.74 elderly patients took a prone position （prone position group）, 46, the lateral position （lateral position group）, comparing the vertebral height, Cobb angle, and VAS score of the two groups before operation and 3d and 3months after operation. Results： There was statistical significance in the vertebral height between the two groups before operation （F=4.231, P=0.042）, and the vertebral height of the two groups 3d and 3 months after operation was significantly higher than that before operation, with statistical significance （F=4.03, P=0.047）. There was no statistical significance in the Cobb angle changes between the two groups before operation （F=3.042, P=0.072）, but the mean Cobb angle of the two groups 3d and 3 months after operation was significantly lower than that before operation,with statistical significance （F=9.86, P=0.021）. The VAS score in the two groups had no significant difference before operation （F=2.035, P=0.089）, but the VAS score of the two groups 3d and 3 months after operation was significantly lower than that before operation,with statistical significance （F=12.86, P=0.005）. Conclusion： Vertebroplasty has an obvious curative effect in the treatment of elderly osteoporotic spinal fracture, which can effectively restore the vertebral height and Cobb angle, and quickly relieve the symptoms of pain.