经皮椎体后凸成形术治疗骨质疏松性胸腰椎骨折的疗效评价

Therapeutic evaluation of percutaneous kyphoplasty for osteoporotic thoracolumbar fracture

目的：探讨经皮椎体后凸成形术（PKP）治疗骨质疏松性胸腰椎骨折的临床效果。方法：回顾分析126例骨质疏松性胸腰椎骨折患者的临床资料，所有患者均以PKP方法进行治疗；临床疗效评估采用视觉模拟评分（VAS）和Oswestry功能障碍指数（ODD，在X线片上测量椎体高度和后凸畸形角度。结果：术后随访10～24个月，平均18个月，患者VAS评分由术前的（7．9±1．2）分下降至术后24h的（3．2±1．1）分，末次随访时为（2．1±0．8）分；ODI评分术前为83．7±4．9，术后24h为33．2±3．9，末次随访时为27．8±3．6。患者术前椎体平均高度为（18．2±3．2）mm，术后24h为（25．8±3．1）mm，末次随访时为（24．9±3．2）mm；术前平均后凸畸形角度为17．2°±3．2°，术后24h为8．4°±3．1°，在末次随访时平均后凸畸形角度为9．1°±3．1°，术后24h、术后6个月及末次随访时各指标与术前比较差异均有统计学意义（P〈0．05）；术后24h、术后6个月及末次随访时各指标比较差异无统计学意义（P〉0．05）。结论：PKP是治疗骨质疏松性胸腰椎骨折的有效方法，能迅速缓解疼痛，有效恢复骨折椎体高度及纠正后凸畸形角度。

Objective To investigate the clinical effect of percutaneous kyphoplasty（PKP） for curring osteoporotic thoracolumhar fracture. Methods The clinical data of 126 patients With osteoporotic thoracolumbar fracture were retrospectively analyzed. The patients were treated with PKP. The clinical effect was assessed by visual analogue scale （VAS） and oswestry disability index （ODD. The vertebral height and kyphotic angle were measured in X-rays plain-film. Results All patients were followed up 10 to 24 months with an average of 18 months. The VAS scores of the patients before operation, 24 h after operation, and at final follow-up were 7.9±1.2, 3.2±1.1, and 2.1± 0.8 ; the ODI were 83.7 ± 4.9, 33.2 ± 3.9, and 27.8 ± 3.6. respectively. The vertebral heights were （18.2±3.2） mm, （25.8±3.1） mm, and （24.9±3.2） mm, respectively; the kyphotic angles were 17.2°±3.2°, 8.4°±3.1, and 9.1°± 3.1°, respectively. There were significant differences of all four indexes between 24 h after operation, 6 months after operation, final follow-up and before operation（P〈0.05）, but there were no significant differences of all four indexes between 24 h after operation, 6 months after operation and final follow-up（P〉0.05）. Conclusion PKPis effective for treatment of osteoporotic thoracolumbar fracture, which can expeditiously relieve pain and effectively recover the vertebral height and kyphotic angle.