经皮椎体成形术治疗胸腰椎骨质疏松性压缩骨折疗效及相关因素分析

Curative effect of percutaneous vertebroplasty on thoracolumbar osteoporotic vertebral compression fractures and its influencing factor

目的探讨经皮椎体成形术(PVP)在治疗胸腰椎骨质疏松性压缩骨折的疗效。方法选择我院收治的骨质疏松性胸腰椎压缩骨折患者共176例,患者根据治疗方式不同分为PVP组及经皮椎体后凸成形术(PKP)组,PVP组102例,PKP组74例。比较两组患者手术时间、住院时间、骨水泥注射量、Cobb角及治疗有效率,VAS评分评估两组手术前后疼痛情况。结果 PVP组手术时间、住院时间均显著低于PKP组(P<0.05)。PVP组及PKP组术后24 h及术后1个月的VAS评分均显著低于术前(P<0.05)。PVP及PKP组术后Cobb角均较术前显著降低(P<0.05)。治疗有效率比较,PVP及PKP组差异无统计学意义(P>0.05)。PVP组病程<6个月的患者治疗有效率(98.4%)显著高于病程≥6个月的患者(73.6%)(P<0.05)。结论经皮椎体成形术是治疗胸腰椎骨质疏松性压缩骨折的有效、可行的方法,病程长短会影响椎体成形术的治疗有效率。

Objective To discuss the curative effect of percutaneous vertebroplasty （PVP） on thoracolumbar osteoporotic vertebral compression fractures. Methods A total of 176 patients suffering thoracolumbar osteoporotic vertebral compression fractures were enrolled in and divided into two groups according to different treatment ways, including PVP group （n = 102） and percutaneous ky- phoplasty （PKP） group （n = 74）. Such parameters, as operation time, hospitalizing duration, amount of injection bone cement, Cobb＇ s angle, treatment effectiveness and VAS pain grade, were compared between the two groups. Results The operation time and hospitalizing duration of the PVP group were obviously less than that of the PKP group （ P 〈 0.05 ）. The VAS pain grade o~ both the two group was also obviously less at 24 hours and in 1 month after surgery than before （P 〈 0.05 ）. Cobb＇ s angle of the two groups was apparently less after surgery than before （ P 〈 0.05 ）. There was no significant difference in treatment effectiveness between the two groups （P 〉 0.05 ）. In the PVP group, the treatment effectiveness was obviously higher in the patients with the disease course less than 6 months than in those with the course equal to or more than 6 months （98.4% vs. 73.6% , P 〈 0.05 ）. Conclusion PVP is an effective and practical way to the treatment of thoracolumbar osteoporotic vertebral compression fractures, which may be influenced by the course of the disease.