开放后凸成形术治疗老年骨质疏松患者脊柱爆裂骨折效果分析

Effect analysis of Open kyphoplasty treatment of osteoporotic patients with spinal burst fracture

目的:探讨开放后凸成形术治疗老年骨质疏松脊柱爆裂骨折(OBVF)的疗效。方法:选择本院2006年10月～2010年5月收治的老年骨质疏松脊柱爆裂骨折患者30例,全部行椎板切除,椎管减压联合开放后凸成形术,采用视觉模拟评分(VAS)及Oswestry功能指数(ODI)评分评价患者手术前后疼痛缓解情况、脊柱功能改善情况,记录前后Cobb角度改变情况。结果:全部患者手术成功,术后随访1年。本组发生3例骨水泥外渗,2例切口脂肪液化,未出现脊髓神经损伤并发症。全部患者术后1周及术后1年时VAS评分、ODI评分、Cobb角度均较治疗前降低,前后差异有统计学意义(t=6.793,4.732,5.314,P<0.05)。术后1年VAS评分、ODI评分较术后1周轻微升高,但是差异无统计学意义(t=0.817,1.326,P>0.05),术后1年Cobb角度较术后1周有所降低,差异亦无统计学意义(t=1.022,P>0.05)。结论:开放后凸成形术治疗老年骨质疏松脊柱爆裂骨折患者,可迅速缓解疼痛,改善脊柱功能,并且远期稳定性较好,适用于年龄较大、合并症较多的老年患者。

Objective： To investigate the effect of open kyphoplasty in treatment of osteoporotic patients with spinal burst fracture. Methods： Thirty cases of osteoporotic patients with spinal burst fracture in our hospital in October 2006 to May 2010 were treated with open kyphoplasty, lamineetomy, spinal decompression, VAS and Oswestry functional index （ODI） score were used to evaluate the pain relief and improvement of spinal function, change of Cobb angle before and after was recorded. Results： Surgery were all successful, patients were followed up for 1 year. There were 3 cases of bone cement leakage, 2 cases of wound seroma in this article, no complication of spinal cord injury was found. The VAS score, ODI score, Cobb angle of 1 week and l year after treatment were lower than before, the difference was statistically significant （t=5.314,6.793,4.732,P〈0.05）. VAS score and ODI score after 1 year was slightly higher than l week after treatment, but the difference was not statistically signifieant（t=0.817,1.326,P〉0.05）, Cobb angle of 1 week and one year after had no significant difference （t=1.022,P〉0.05）. Conclusion： Open kyphoplasty treatment of osteoporotic spinal burst fracture, can quickly relieve pain and improve spinal function and better long-term stability, suitable for older, more complications in elderly patients.