球囊扩张椎体后凸成形术治疗病理性椎体压缩骨折的疗效分析

Clinical Results of Percutanueous Balloon Kyphoplasty in Treatment of Pathologic Vertebral Compression Fractures

目的探讨球囊扩张椎体后凸成形术治疗病理性椎体压缩骨折的短中期疗效。方法回顾分析2002年10月～2007年12月收治的53例病理性椎体压缩骨折,将患者按随访时间长短分为两组,A组4～24个月,B组24～56个月,将所调查的数据经统计学处理,比较组间疗效、影像学变化特点,分析影响手术疗效的相关因素。结果临床疗效总优良率81.13%,两组优良率比较差异无统计学意义。两组VAS、JOA、ODI评分术前与术后比较差异有统计学意义,术后与末次随访比较差异无统计学意义,A组与B组比较差异无统计学意义。两组椎体前缘、中部高度术前与术后比较差异有统计学意义,术后及末次随访差异无统计学意义,A组与B组比较差异无统计学意义。慢性病史、类固醇服药史是影响手术疗效的不利因素。腰背肌锻炼史及抗骨质疏松服药史是影响手术疗效的有利因素。结论球囊扩张椎体后凸成形术治疗病理性椎体压缩骨折的短中期临床疗效满意。

Objective To review and analyze the short intermediate term curative effect in patients with pathologic vertebral compression fracture after percutanueous balloon kyphoplasty.Methods From 2002 to 2007,there were 53 cases who had an operation.All patients were divided into two groups,group A（4～24 months）,group B（24～56 months）.The data was analyzed to compare the improvement rate of the patients and radiographic characteristics with different follow-up group.Results The total good rate of the 53 cases was 81.13%,there was no statistical difference between group A and group B.In two groups,there was statistical difference between the pre-operative and post-operative height of anterior and middle portion of the vertebral body,there was no statistical difference between the post-operative and last follow-up the height of anterior and middle portion of the vertebral body,there was no statistical difference between group A and group B.In two groups,there was statistical difference between the pre-operative and post-operative scores of VAS,JOA and ODI,there was no statistical difference between the post-operative and last follow-up of the scores of VAS,JOA and ODI,there was no statistical difference between group A and group B.The chronic diseases and history of steroid drug were the negative factors of surgical outcomes while history of exercise for back muscle,history of antiosteoporotic drug were the positive factors of surgical outcomes.Conclusion In the short intermediate follow-up,the clinical curative effect is satisfied.