经皮椎体后凸成形术与保守治疗老年性急性骨质疏松性椎体压缩骨折疗效观察

Compared the Treatment of Osteoporotic Vertebral Compression Fractures by Angioplasty Percutaneous Vertebral Kyphosis (PKP) and the Conservative

目的比较经皮椎体后凸成形术(PKP)与保守治疗骨质疏松性椎体压缩骨折(OVCF)的疗效。方法 2009年1月至2010年7月采用PKP技术(PKP组)治疗50例,保守疗法(保守治疗组)治疗50例OVCF患者,PKP组患者50例,男20例,女30例;年龄65～90岁,平均81岁。保守治疗组50例,男18例,女32例;年龄65～89岁,平均78岁。术后观察症状改善情况、椎体高度恢复率,采用视觉模拟评分(VAS)评定疼痛程度;椎体高度:在X线片上测量椎体前壁高度、计算椎体高度百分率。结果患者术后获3～12个月(平均9个月)随访。两组患者VAS评分术前、术后3个月和末次随访时比较差异均无统计学意义(P>0.05),两组术后24h内比较差异有统计学意义(P<0.05)。PKP组术前椎体前壁、后壁高度比与术后高度比比较差异有统计学意义(P<0.05),PKP组术后与保守治疗组比较差异有统计学意义(P<0.05)。结论与保守治疗组相比,早期采用PKP技术具有即刻减轻痛苦、早期起床活动、恢复椎体高度、减少并发症等优点。保守治疗组经过3～6个月严格保守治疗也能达到症状减轻,但椎体高度恢复不佳。

Objective To compare angioplasty percutaneous vertebral kyphosis （PKP） and the conservative treatment of osteoporotic vertebral compression fractures （OVCF） efficacy.Method from January 2009 to July 2010 using PKP （PKP group） to treat 50 cases of treatment, conservative treatment （conservative treatment group） to treat 50 cases of patients with OVCF of PKP group of 50 patients, 20 males; 30 females; age from 65 to 90 years old, an average of 81years; 50 cases of conservative treatment group, 18 males and 32 females; ranging in age from 65 to 89 years old, with an average age of 78.Were observed after the improvement of symptoms, vertebral body height restoration rate, using a visual analog scale （VAS） to assess the degree of pain; vertebral height measurement of the vertebral body anterior wall height： X-ray films, calculation of vertebral height percentage. Results of patients received 3 to 12 months （mean 9 months）. The two groups in VAS pain score before surgery, 3 months after surgery and last follow-up showed no significant difference （P0.05）, postoperative 24h difference was statistically significant （P0.05）. Vertebrae anterior, posterior height of the PKP Group of preoperative than with postoperative height difference was statistically significant （P0.05） of PKP group was compared with the conservative treatment group difference was statistically significant （P0.05）.Conclusions the conservative treatment group compared to the early adopters the PKP technology to instantly relieve suffering, and early to get up, restore vertebral height, reducing complications and advantages. The conservative treatment group after 3 to 6 months of strict conservative treatment to achieve symptom relief, vertebral height restoration poor.