早期行椎体球囊成形术治疗胸腰椎骨质疏松性压缩性骨折的效果及影响因素分析

Analysis of the curative efficacy and influencing factors of early percutaneous kyphoplasty in the treatment of osteoporotic compression fracture of thoracolumbar spine

【目的】分析早期行椎体球囊成形术(percutaneous kyphoplasty,PKP)治疗胸腰椎骨质疏松性压缩性骨折(osteoporotic compression fracture of thoracolumbar spine,OCFTS)的效果及影响因素。【方法】回顾性分析在本院行PKP治疗OCFTS的96例患者资料,按照患者骨折至接受手术的时间分为两组,早期组患者在骨折后7 d内进行手术治疗,中晚期组患者在骨折后8~30 d进行手术治疗。比较两组患者疼痛视觉模拟量表(visual analogue scale,VAS)评分、疗效以及OCFTS疗效的影响因素。【结果】早期组患者术后24 h、术后3个月、术后1年VAS评分均明显低于中晚期组,差异有统计学意义(P<0.05)。早期组患者骨折恢复优良率为82.61%,明显高于中晚期组的52.00%,差异有统计学意义(P<0.05)。早期组优良患者椎体压缩程度、骨折椎体数量均明显低于非优良患者,骨水泥渗漏发生率明显低于非优良患者,术后1年规范抗骨质疏松治疗率明显高于非优良患者,差异均有统计学意义(P<0.05)。多因素分析显示,椎体压缩程度≥1/2、术后1年规范抗骨质疏松治疗、有骨水泥渗漏为影响早期行PKP治疗OCFTS效果的独立危险因素(P<0.05)。【结论】早期行PKP治疗OCFTS的效果较好,椎体压缩程度、术后1年规范抗骨质疏松治疗、有无骨水泥渗漏为治疗效果的影响因素。

【Objective】To analyze the efficacy and influencing factors of early percutaneous kyphoplasty(PKP)in the treatment of osteoporotic compression fracture of thoracolumbar spine(OCFTS).【Methods】The data of 96 cases with OCFTS undergoing PKP treated in our hospital were analyzed retrospectively.According to the time from fracture to operation,the patients were divided into two groups.The patients in the early group were operated within 7 days after fracture,and those in the middle and late group were operated within 8~30 days after fracture.The score of visual analogue scale(VAS),efficacy of OCFTS and its influencing factors were compared between the two groups.【Results】The VAS scores in the early group 24 h,3 months and 1 year after operation were significantly lower than those in the middle and late group(P<0.05).The excellent rate of fracture recovery in the early group was 82.61%,which was significantly higher than that in the middle and late group(52.00%)(P<0.05).In the early group,the compression degree of vertebral body and number of fractured vertebral body were significantly lower than those in the non-excellent patients,the rate of leakage of bone cement was significantly lower than that in the non-excellent patients,and the rate of standardized anti osteoporosis treatment was significantly higher than that in the non-excellent patients one year after operation(P<0.05).Multivariate analysis showed that vertebral compression degree≥1/2,standard anti-osteoporosis treatment one year after operation and leakage of bone cement were independent risk factors(P<0.05).【Conclusion】The early PKP for OCFTS is of good therapeutic efficacy.The degree of vertebral compression,the standardized anti-osteoporosis treatment one year after operation and the leakage of bone cement are the influencing factors.