经皮椎体后凸成形术骨水泥位置对术后疗效影响的对比分析

Effect of different PMMA's positions in treatment of osteoporotic vertebral compression fractures with percutaneous kyphoplasty

[目的]比较经皮椎体后凸成形术治疗骨质疏松压缩骨折术后骨水泥(poly methyl meth acrylate,PMMA)在椎体中的位置对疗效的影响。[方法]回顾性分析经皮椎体后凸成形术治疗骨质疏松椎体压缩骨折(单椎体)98例患者。根据术后骨水泥在椎体中的位置分为两组:侧方组(骨水泥偏于椎体一侧,未过中线)42例,中位组(骨水泥偏于椎体中央,越过中线)56例。测量并比较两组以下指标:手术前后VAS评分(10分制视觉模拟评分),ODI评分(Oswestry功能障碍指数,Oswestry disability index),SI(椎体矢状面指数,sagittal index,SI=椎体前缘高度/椎体后缘高度)及Cobb角。[结果]两组VAS、ODI评分、SI及Cobb角术前术后比较有统计学意义(P<0.05);术前及术后两组间相比,VAS、ODI评分、SI及Cobb角均无统计学意义(P>0.05);2组病例均未见患椎侧方再压缩。[结论]经皮椎体后凸成形术治疗骨质疏松椎体压缩骨折有较好的临床疗效,骨水泥在椎体中的分布位置对疗效没有显著影响,骨水泥偏一侧者不会增加椎体再次侧方压缩的风险。

[Objective]To compare the effects of polymethylmethacrylate（PMMA） positions in treatment of osteoporotic vertebral compression fractures（OVCF）with percutaneous kyphoplasty.[Method]This study retrospectively analyzed 98 OVCF cases（single vertebral body） treated with percutaneous kyphoplasty.Based on the different PMMA positions,the patients were divided into 2 groups：lateral-group（the PMMA position located on one side of vertebrae,n= 42）,and central-group（the PMMA position located on the center of vertebrae,n=56）.Visual analogue pain scale,Oswestry disability index,sagittal index and Cobb＇s angle were measured preoperatively and postoperatively.[Result]There was significant differences in visual analogue pain scale（VAS）,Oswestry disability index（ODI）,sagittal index（SI） and Cobb＇s angle of each group preoperatively versus postoperatively（P0.05）.No statistical difference was noted in the VAS,ODI,SI and Cobb＇s angle between the two groups preoperatively versus postoperatively（P0.05）.No recompressed case was found in both groups.[Conclusion]Percutaneous kyphoplasty could obtain better clinical therapeutic effect in OVCF treatment.Different PMMA positions had no significant influence on the therapeutic results.The risk of the vertebra recompression could not increase when the PMMA was located at one side in the vertebra.