经皮椎体成形术与非手术治疗骨质疏松性椎体压缩骨折的疗效的临床对照研究

Controlled clinical study of percutaneous vertebralplasty versus non-surgical treatment of osteoporosis vertebral compression fractures in curative effect

目的探讨分析PVP与非手术治疗骨质疏松性椎体压缩骨折(OVCF)在疼痛缓解、椎体高度及畸形矫正、提高患者的生活质量的疗效。方法回顾性分析自2005-09—2011-10诊治的124例OVCF,其中42例行PVP(A组),42例行非手术治疗(B组),术后常规摄伤椎X线片,术后6、12、24、36个月进行随访,记录患者疼痛视觉评分(VAS)、伤椎前缘高度(h)、Cobb角(α)及生活质量(QOL),评估2组临床疗效。结果经过数据分析,2组基线学数据比较差异均无统计学意义(P>0.05),A组伤椎前缘高度、后凸畸形的矫正、疼痛缓解及生活质量改善方面均优于B组,差异有统计学意义(P<0.05)。A组与B组邻近节段发生骨折率分别为7.5%和11.2%,差异无统计学意义(P>0.05)。结论 PVP在治疗OVCF的疗效较好,能缓解患者的长期腰背疼痛,避免椎体进一步压缩,提高患者生活质量,很少有邻近节段的再发骨折。

Objective To study the curative effect of PVP and non-surgical treatment of OVCF in pain relief, vertebral body height and deformity correction and improve the patients＇ quality of life. Methods From September 2005 to October 2011 our department treated 124 patients with OVCF related to treatment. The patients were randomly selected to undergo PVP as group A（42 patients） and non-surgical treatment as group B（42 patients）. The X-ray films of the spine, 6, 12, 24, and 36 months follow-up, patients pain visual score（VAS）, anterior flange height（h）, Cobb Angle（ α） and the evaluation of the quality of life（QOL） were observed in the two groups. Results There were no significant differences in baseline data between two groups（P 〉0.05）. In long term group A in loss of the vertebral body height, the protrusion deformity correction, the long-term pain relief and quality of life improvement was better than that of group B, the difference was statistically significant（ P〈 0.05）.In group A and group B adjacent segmental fracture rate were 7.5%, and 11.2% respectively, there was no statistically significant difference（P 〉0.05）. Conclusion PVP is better than non-surgical treatment in treatment of OVCF forward curative effect. It can relieve the patients＇ lower back pain for a long time, avoid further compression vertebral body, improve the patients＇ quality of life. There are few adjacent segment re-fracture.