椎体后凸成形术治疗多发性老年骨质疏松脊柱椎体骨折的临床疗效

Investigation on the clinical effect of kyphoplasty in the treatment of vertebral fractures in elderly patients with multiple osteoporosis

目的:探讨椎体后凸成形术治疗多发性老年骨质疏松脊柱椎体骨折的效果。方法:2017年12月-2019年12月收治多发性老年骨质疏松脊柱椎体骨折患者110例,随机分为两组,各55例。对照组采用经皮椎体成形术治疗;试验组应用椎体后凸成形术治疗。比较两组临床指标、手术指标、血清睾酮(T)、胰岛素样生长因子(IGF)和Ⅰ型胶原交联的水平C-末端肽(CTX-1)水平。结果:试验组治疗后伤椎前缘高度高于对照明,Cobb角、Oswestry功能障碍指数(ODI)评分低于对照组,差异有统计学意义(P<0.05);试验组手术时间长于对照组,骨水泥渗漏率低于对照组,差异有统计学意义(P<0.05);试验组治疗后T、IGF水平高于对照组,CTX-1水平低于对照组,差异有统计学意义(P<0.05)。结论:应用椎体后凸成形术治疗多发性老年骨质疏松脊柱椎体骨折患者的效果显著,提高脊柱功能,降低骨水泥渗漏对神经功能损伤,改善骨质疏松相关因子水平,促进患者康复。

Objective:To investigate the effect of kyphoplasty in the treatment of vertebral fractures in elderly patients with multiple osteoporosis.Methods:From December 2017 to December 2019,110 elderly patients with multiple osteoporotic spinal vertebral fractures were selected,they were randomly divided into the two groups with 55 cases in each group.The control group was treated with percutaneous vertebroplasty.The experimental group was treated with kyphoplasty.The clinical index,surgical index,serum T,IGF and CTX-1 levels were compared between the two groups.Results:After treatment,the height of the anterior edge of the injured vertebra in the experimental group was higher than that in the control group,the Cobb angle and ODI in the experimental group were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The operation time in the experimental group was significantly longer than that in the control group,and the bone cement leakage rate in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).After treatment,the levels of T and IGF in the experimental group were significantly higher than those in the control group,while the level of CTX-1 in the experimental group was significantly lower than that in the control group,the difference was statistically significant(P<0.05).Conclusion:Kyphoplasty is effective in the treatment of vertebral fractures in elderly patients with multiple osteoporosis,which can improve the spinal function,reduce the neurological damage caused by bone cement leakage,improve the level of osteoporosis-related factors and promote the rehabilitation of the patients.