陈旧性与新鲜性压缩骨折行椎体成形术的临床对比研究

Clinical comparative study of vertebroplasty both on the old and fresh compression fracture

目的回顾性对比研究陈旧性与新鲜性椎体压缩性骨折行经经皮椎体成形术(percutaneouss vertebra plasty,PVP)后的临床效果。方法对24例老年骨质疏松性胸腰椎压缩性骨折患者行PVP治疗,将研究对象按陈旧性骨折和新鲜性骨折分为2组,分别拍摄2组术前、术后标准正侧位X线片,从而对骨折椎体高度的恢复、后凸畸形的矫正及疼痛视觉模拟量表(visual analogue scale,VAS)评分进行研究对比。结果所有患者术后平均随访6个月,无严重并发症发生。2组患者术后疼痛缓解且恢复良好,均恢复日常活动能力。但陈旧性压缩性骨折患者术后椎体高度恢复和后凸畸形的矫正程度均不如新鲜性骨折患者。结论 PVP术操作简单、创伤小,对于骨质疏松性椎体压缩性骨折的治疗效果明显,尤其对新鲜骨折效果显著,且对于缓解陈旧性骨折疼痛症状也有良好效果。

Objective To retrospectively compare the clinical outcomes of percutaneous vertebroplasty（PVP） in treatment of old and fresh vertebral compression fractures.Methods Totally 24 elderly with osteoporotic thoracolumbar vertebral compression fractures were treated by PVP and divided into old fracture group and fresh fracture group.Standard anteroposterior and lateral roentgenographs were taken before and after PVP so as to contrast the recovery of vertebral height,correction of kyphosis,and pain visual analogue scale（VAS） score between the two groups.Results The mean duration of follow-up was 6 months for all the patients.No severe complications happened.Patients in both groups achieved significant pain relief and resumed daily activities.But the restoration of vertebral height and kyphotic correction in the old compression fractures were not as good as fresh fractures.Conclusion Percutaneous vertebroplasty is a simple and minimally invasive surgery.There are obvious clinical outcomes for osteoporotic vertebral compression fractures（especially for fresh fractures） by PVP.Meanwhile,it is a good way to relieve pain for old fractures.