PVP与PKP治疗骨质疏松性胸腰椎压缩性骨折的临床疗效观察

The Clinical efficacy Observation for the treatment of osteoporotic vertebral compression fractures by Percutaneous vertebroplasty and percutaneous kyphoplasty

目的:探讨并比较经皮椎体成形术与椎体后凸成形术治疗骨质疏松性胸腰椎压缩性骨折的临床疗效。方法:病例资料选自我院2005年9月～2009年12月期部接受椎体成形手术的患者,共44例,其中PVP治疗组31例39椎;PKP治疗组13例22椎,观察两组手术前后椎体前缘、中部高度的恢复情况和后凸畸形Cobb角度的改善情况,疼痛视觉模拟评分(visualanaloguescale,VAS),日常生活活动能力评分(巴塞尔指数BI),评价临床疗效。结果:术后两组疼痛视觉模拟评分(VAS),日常生活活动能力评分(巴塞尔指数BI),与术前比较差异有统计学意义(P<0.05),两组间VAS评分和BI评分差值比较无统计学意义(P>0.05);术后两组椎体前缘和中部高度丢失率,PVP组与术前比较差异无统计学意义(P>0.05);PKP组与术前比较差异有统计学意义(P<0.05),两组间高度丢失率差值比较差异有统计学意义(P<0.05);术后两组Cobb角的改善,PVP组术后与术前比较差异无统计学意义(P>0.05),PKP组术后与术前比较差异有统计学意义(P<0.05),两组间Cobb角差值比较差异有统计学意义(P<0.05)。结论:采用PVP及PKP治疗骨质疏松性胸腰椎压缩性骨折均能够迅速地改善临床症状。PKP可有效恢复病椎高度、纠正后凸畸形,但价格昂贵;PVP组操作简便,疗效确切且价格便宜,利于推广应用。

Objective：Exploring clinical efficacy for the treatment of osteoporotic vertebral compression fractures by percutaneous vertebroplasty （percutaneous vertebra - plasty, PVP） or by pereutaneous vertebroplasty （ pereutaneous kyphoplasty, PkP） and comparing them. Methods ： Patients received PVP or PkP collected from 9, 2005 to12,2009 in our hospital,totally 44eases,including 31cases（39cone） pvp and 13cases（22cone）. By comparing anterior vertebral between preoperative and post- operative, central high loss rate, the improvement of the situation kyphosis Cobb angle, visual analogue pain score （visual analogue scale, VAS） , and the capability of liv- ing score （Barthel Index） , Counting index changes observed in the same group before and after surgery and the difference changes in indicators between the groups before and after surgery to evaluate the clinical efficacy. Result： There is significant difference （ P 〈 0. 05 ） between preoperative and postoperative in Patients on visual analogue pain score （VAS） and Activities of daily living score （Barthel Index BI） , there is No statistically significant （P 〉 0. 05） between the two groups on VAS score and the BI score; there is not significant difference （P 〉 0. 05 ） between preoperative and postoperative in PVP group on anterior vertebral height loss rate and the central;there is Significance （P 〈 0. 05 ） between preoperative and postoperative in PkP group on anterior vertebral height loss rate and the central, there is statistically significant difference （P 〈 0. 05 ） between the two groups on anterior vertebral height loss rate;about improved postoperative Cobb angle of the two groups, PVP group were reduced by an average （ 3.41 ± 2.75 ） , there was not significant difference （ P 〉 0.05 ） Compared with the preoperative, PKP group were reduced by an average （ 8.73 ± 2.46） , there is significant difference （ P 〈 0.05 ） compared with the preoperative, there is statistically significant difference （ P 〈 0. 05 ） between the two groups on Cobb angle. Conclusion ：PVP and PKP were able to rapidly improve clinical symptoms for treatment of osteoporotic thoraeolumbar vertebral compression fractures. PKP can effectively restore vertebral height and correct kyphosis, but expensive;PVP group is simple, effective and inexpensive, which will help expand the applications.