经皮球囊扩张后凸成形术与非手术疗法治疗骨质疏松性椎体压缩性骨折的疗效比较

Clinical comparison between PKP and conservative therapy in treatment of osteoporotic thoracolumbar vertebral compression fracture

目的比较经皮球囊扩张后凸成形术(PKP)与非手术疗法治疗骨质疏松性椎体压缩性骨折的疗效。方法选择2010年1月—2013年l月我院收治的骨质疏松性椎体压缩性骨折患者118例,根据患者自身要求分为PKP组(63例)和非手术组(55例),比较两组患者治疗前后疼痛视觉模拟评分(VAS评分)、椎体前缘高度。结果两组治疗后1周及治疗后半年随访时VAS评分与治疗前比较,差异均有统计学意义(P<0.05);同期组间比较,治疗后1周两组VAS评分差异有统计学意义(P<0.05),治疗后半年两组VAS评分差异无统计学意义(P>0.05)。两组组内治疗前与治疗后半年椎体前缘高度比较差异有统计学意义(P<0.05),但非手术组的椎体前缘高度比治疗前降低;组间同期比较,治疗后1周、治疗后半年两组椎体前缘高度比较,差异有统计学意义(P<0.05)。结论 PKP可迅速缓解疼痛,但对于远期疼痛缓解程度,非手术治疗与PKP相当,PKP能改善椎体高度,有利于重建脊柱,但长期非手术治疗会导致椎体高度丧失。

Objective To compare the clinical effect of percutaneous kyphoplasty （PKP） with that of conservative therapy in treat- ment of osteoporotic thoracolumbar vertebral compression fractures. Methods A total of 118 osteoporotic patients with thoraeolum- bar vertebral compression fracture admitted from January 2010 to January 2013 were divided into PKP group （n = 63 ） and non-PKP （conservative therapy） group （n = 55）. Visual analog scale （VAS） and vertebral height were compared between the two groups. Results There were significant differences in VAS after 1 week and 6 month in both the two groups when compared with before treatment （ P 〈 0.05 ）. Between the two groups, the difference in VAS was significant after 1 week （ P 〈 0.05 ） and was not signifi- cant after 6 months （P 〉 0.05 ）. As for anterior vertebral height, there were significant differences in both the two groups after 6 months when compared with before treatment （P 〈 0.05 ） , but in non-PKP group the anterior vertebral height was reduced. There were significant differences in anterior vertebral height between the two groups in the same period of 1 week and 6 months after treat- ment （ P 〈 O. 05 ）. Conclusion PKP can quickly relieve pain, hut long-term pain relief of conservative treatment is similar to that of PKP. PKP can improve vertebral height and is conducive to reconstruction of spinal balance, but long-term conservative treatment will lead to the loss of vertebral height.