不同手术方法治疗骨质疏松性椎体压缩骨折的临床对比研究

COMPARATIVE RESEARCH ON DIFFERENT SURGICAL METHODS FOR THE TREATMENT OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURES

目的探讨骨质疏松性椎体压缩骨折患者不同手术治疗方法的临床应用价值。方法将2005年5月—2011年2月骨质疏松性椎体压缩骨折患者72例随机分成2组,试验组36例,对照组36例。对照组采用经皮椎体成形术治疗;试验组采用经皮椎体后凸成形术治疗。观察比较2组椎体高度压缩率、伤椎Cobb's角度、视觉模拟评分法(visual analogue scale,VAS)疼痛评分、功能障碍评分以及并发症的发生情况。结果试验组术后1、6、12个月椎体高度压缩率和伤椎Cobb's角度显著低于对照组(P<0.05);试验组术前、术后的VAS和功能障碍评分与对照组相比差异无统计学意义(P>0.05);试验组的总不良反应发生率为13.89%,显著性低于对照组的36.11%(P<0.05)。结论经皮椎体后凸成形术应用于骨质疏松性椎体压缩骨折治疗的临床效果显著。

Objective To investigate the clinical value about different surgical treatment for osteoporotic vertebral compression fractures. Methods Seventy-two patients with osteoporotic vertebral compression fractures admitted to hospital from May 2005 to February 2011 were randomly divided into two groups, control group （ n = 36 ） and treatment group （ n = 36 ）. The control group was treated with percutaneous vertebroplasty （PVP）, and the treatment group was treated with percutaneous kyphoplasty （PKP）. The vertebral height compression ratio ,injured vertebra Cobb＇s angle, the score of visual analogue scale （VAS） and Oswestry disability index （ ODI）, and the occurrence of complications in 2 groups was observed and compared. Results The vertebral height compression ratio and injured vertebra Cobb＇s angle one month, six months, 12 months after surgery in the treatment group were Significantly lower than the control group （P 〈 0.05 ） ; the scores of VAS and ODI in the treatment group were similar with the control group（P 〉0.05） ; the total adverse reactions rate was 13.89% in the treatment group, but the control group was 36.11%, so the occurrence of complications in the treatment group was significantly less than the control group （P 〈 0.05 ）. Conclusion There is a significant clinical effect of PKP for osteoporotic vertebral compression fractures.