球囊扩张椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折的疗效评价

Curative effect evaluation of senile osteoporotic vertebral compression fractures with balloon kyphoplasty

目的探讨球囊扩张椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折的疗效及安全性。方法回顾性分析我院2008年7月至2012年7月80例老年骨质疏松脊柱压缩骨折患者的临床资料,手术前后分别进行视觉模拟疼痛评分(visual analog scale,VAS),椎体前缘高度、中缘高度、Cobb’s角测量以及患者生活质量评分。结果本组患者术后疼痛均得到有效控制,术前椎体前缘高度与中缘高度分别为(56.02±12.08)%、(58.19±13.11)%,术后分别为(72.10±16.19)%、(78.33±19.02)%,较术前均有明显恢复;VAS评分由术前的(8.31±1.22)分降低至术后的(1.65±0.33)分;Cobb’s角由术前的(24.12±3.28)°降低至术后的(13.56±2.05)°。手术前后前缘高度、中缘高度、VAS评分及Cobb’s角度差异均具有统计学意义(P<0.05)。并发症发生率由术前的23.75%降低至术后的1.25%,二者差异具有显著的统计学意义(P<0.01)。根据QLQC-30生活质量评分,患者术后生活质量明显优于术前,各项统计指标差异均有统计学意义(P<0.05)。结论球囊扩张椎体后凸成形术治疗老年骨质疏松脊柱压缩骨折,疗效显著,安全性高,值得临床推广应用。

Objective To study the curative effect and safety of senile osteoporotic vertebral compression fractures with balloon ky- phoplasty. Methods The clinical data of 80 patients in our hospital during July 2008 to July 2012 with senile osteoporotic vertebral compres- sion fractures were analysed retrospectively. And the clinical effect was evaluated by observing the charges of visual analog scale （VAS） , height of vertebral bodies and Cobb＇ s angle, the quality of life score in patients respectively before and after operation. Results The pain of the patients were controlled effectively after operation, and the patients had significant and sustained improvement in anterior and midline ver- tebral body height after operation, with （56.02 ＋ 12.08） % and （58.19 -＋ 13.11 ） % before preoperation respectively, and （72. 10 -＋ 16.19） % and （78.33 ＋ 19, 02） % after surgery respectively. VAS score reduced from （8.31 ＋ 1.22） to （ 1.65 -＋ 0.33 ） after surgery; Cobb＇ s angle reduced from （24.12 -＋ 3.28） ~ to （ 13.56 -＋ 2.05 ） ~ after operation. The differences of the frontal height and flange height, VAS scores, and Cobb＇ s angle before and after operation were statistically significant （ P 〈 0.05 ）. The incidence of complications reduced from 23.75% to 1.25% after operation, which indicates significant difference （ P 〈 0.01 ）. According to QLQC-30 quality of life score, the postoperative life of patients were much better than that of the preoperative life, and the difference of all statistical index were of statistical significance （ P 〈 0.05 ）. Conclusion Balloon kyphoplasty in the treatment of senile osteoporotic vertebral compression fractures has signifi- cant effect and high safety, it should be popularized and applied in clinical.