椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床研究

Clinical research of kyphoplasty in the treatment of osteoporotic vertebral compressive fractures

目的探讨椎体后凸成形术治疗骨质疏松性椎体压缩骨折的临床疗效。方法选择2009年5月～2011年2月石家庄市第一医院收治的骨质疏松性椎体压缩骨折患者32例(45椎)为研究对象,采用椎体后凸成形术治疗。观察患者术后、随访12个月时并发症、视觉模拟评分(VAS)、活动能力评分、使用止痛药物的评分及Cobb角、椎体高度的变化情况。结果术后发生骨水泥渗漏6例,占18.75%。患者术后Cobb角[(20.2±3.8)°]较术前[(29.4±5.3)°]明显减小,差异有统计学意义(P<0.05);而随访12个月时[(19.8±4.1)°]与术后[(20.2±3.8)°]比较,差异无统计学意义(P>0.05)。术后患者VAS评分[(2.4±0.7)分]、活动能力评分[(1.1±0.4)分]及使用止痛药物评分[(0.4±0.1)分]明显降低,与术前比较[(7.9±1.2)、(3.5±0.4)、(1.8±0.7)分],差异均有统计学意义(均P<0.05);而随访12个月时VAS评分[(2.7±0.8)分]、活动能力评分[(1.2±0.5)分]及使用止痛药物评分[(0.3±0.1)分]与术后比较[(2.4±0.7)、(1.1±0.4)、(0.4±0.1)分],差异无统计学意义(P>0.05)。术后患者前缘[(1.25±0.33)cm]、中部[(1.32±0.41)cm]的椎体高度较治疗前[(0.82±0.11)、(0.83±0.30)cm]明显增加,差异均有统计学意义(均P<0.05);而椎体后缘高度手术前后[(2.10±0.60)、(2.31±1.01)cm]差异无统计学意义(P>0.05);随访12个月时前缘、中部、后缘的椎体高度[(1.25±0.32)、(1.32±0.40)、(2.32±1.02)cm]与术后[(1.25±0.33)、(1.32±0.41)、(2.31±1.01)cm]比较,差异无统计学意义(P>0.05)。结论椎体后凸成形术治疗椎体压缩性骨折操作简单方便、并发症少,可明显缓解疼痛,改善患者生存质量。

Objective To explore the clinical effect of kyphoplasty in the treatment of osteoporotic vertebral compres- sive fractures. Methods 32 cases （45 vertebras） of osteoporotie vertebral compressive fractures from May 2009 to February 2011 in the First Hospital in Shijiazhuang City were selected and treated by kyphoplasty. The complications after operation and 12 mouths＂ following-up, VAS scale, activity ability score, use of analgesic drugs score and the Cobb augle, vertebral body height were observed. Results 6 cases of bone cement leakage were found after the opera- tion, the percent was 18.75%. Cobb angle after the operation [（20.2±3.8）°] was lower than that before the operation [（29.4±5.3）°], the difference was statistically significant （P 〈 0.05）; the differeuce of Cobb angle after the operation [（20.2±3.8）°] and 12 months＂ following-up [（19.8±4.1）°] was not statistically siguificant （P 〉 0.05）. VAS scale [（2.4± 0.7） scales], activity ability score [（1.1±0.4） scales], use of analgesic drugs score [（0.4±0.1） scales] after the operation were all lower than those before the operation [（7.9±1.2）, （3.5±0.4）, （1.8±0.7） scales], the difference was statistically significant （P 〈 0.05）; the differences of VAS scale, activity ability score, use of analgesic drugs score after the opera- tion [（2.4±0.7）, （1.1±0.4）, （0.4±0.1） scales] and 12 months＂ following-up [（2.7±0.8）, （1.2±0.5）, （0.3±0.1） scales] were not statistically significant （P 〉 0.05）. Front edge [（1.25±0.33） cm] and middle edge [（1.32±0.41） cm] of vertebral body height after the operation were higher than those before the operation [（0.82±0.11）, （0.83±0.30） cm], the differeuces were statistically siguificant （P 〈 0.05）; the difference of trailing edge of vertebral body height before and after the op- eration [（2.10±0.60）, （2.31±1.01） cm] was not statistically significant （P 〉 0.05）; the differences of front edge, middle edge and trailiug edge of vertebral body height after the operation [（1.25±0.33）, （1.32±0.41）, （2.31±1.01） cm] and 12 months＂ following-up [（1.25±0.32）, （1.32±0.40）, （2.32±1.02） em] was not statistically significant （P 〉 0.05）. Conclusion Kyphoplasty in the treatment of osteoporotic vertebral compressive fractures is simple and convenient, has less complications, it can significantly relieve pain and improve the quality of life.