经皮椎体后凸成形术治疗骨质疏松性椎体空腔样骨折与无空腔样骨折

Percutaneous kyphoplasty for treatment of osteoporotic vertebral fracture with or without cleft

目的比较分析骨质疏松性椎体空腔样骨折与无空腔样骨折行经皮椎体后凸成形术(percutaneouskyphoplasty,PKP)治疗的疗效差异。方法 54例单节段骨质疏松性椎体压缩骨折患者行PKP治疗。其中27例伤椎呈空腔样骨折(A组),27例伤椎无空腔样骨折(B组)。记录并分析2组患者术后疼痛视觉模拟量表(visual analoguescale,VAS)评分及Oswestry功能障碍指数(Oswestry disability index,ODI)改善情况。根据手术前后X线片及CT,比较分析2组伤椎高度、局部Cobb角、骨水泥的注入量及渗漏情况。结果 2组患者术后VAS评分、ODI均得到明显改善,2组间差异无统计学意义(P>0.05);A组椎体高度的恢复和后凸畸形的矫正优于B组,差异有统计学意义(P<0.05);A组骨水泥注入量大于B组,差异有统计学意义(P<0.05);2组骨水泥渗漏率分别为11.1%和7.4%,差异无统计学意义(P>0.05)。结论 PKP治疗2种类型的骨质疏松性椎体骨折均可获得良好的临床疗效,对于空腔样骨折,PKP恢复椎体高度和纠正后凸角的疗效更明显。

Objective To compare the clinical outcome of percutaneous kyphoplasty for treatment of osteoporotic verlebra fracture with or without cleft. Methods A total of 54 patients were performed percutaneous kyphnplasty for treatment of single-level osteoporotic vertebral compression fracture, and 27 patients with intravertebral cleft were selected as Group A, othel 27 cases without intravertebral cleft as Group B. The therapeutic efficacy were compared between the 2 groups wilh visual analogue scale （VAS） scroes and Oswestry disability index （ODI）. The height and the kyphotic angle of the involved w^lt^t~ra body, the injective cenment volum and the rate of cement leakage were compared between the 2 groups. Results All paticnl： were performed the surgical procedure successfully. The VAS score, ODI in 2 groups were similar, and there was no difference between 2 groups （P 〉 0.05 ）. Group A had significant improvement of vertebral height and kyphotic angle of involved vertebral body compared to Group B, and there was some difference between the 2 groups （P 〈 0.05 ）. The cement injection vohm in Group A was greater than Group B, and there was some difference between the 2 groups （ P 〈 0.05）. There was no signifi- cant difference of cement leakage between the 2 groups （ P 〉 0.05 ）. Conclusion Pereutaneous kyphoplasly is an effectiw treatment for osteoporotie vertebral fracture with cleft or without cleft, especially to recover vertebral height and reduce kvohotie angle for osteolaorotic vertebral fracture with cleft.