两种术式治疗中老年骨质疏松性椎体压缩骨折的疗效对比

Efficacy Analysis of Two Surgical Methods in Treating Osteoporotic Vertebral Compression Fracture in the Middle- aged Patients

目的：比较并探讨经皮椎体成形术（PVP）和经皮椎体后凸成形术（PKP）治疗中老年骨质疏松性椎体压缩骨折（OVCF）的疗效。方法：总结2011年2月～2014年1月42例采用PVP和PKP治疗中老年骨质疏松性椎体压缩骨折患各资料，其中23例行PVP治疗，19例行PKP治疗。PVP组：男10例，女13例；PKP组：男8例，女11例。统计两组手术前后Oswestry功能障碍指数（ODI）、疼痛视觉模拟（VAS）评分、椎体前缘高度及Cobb’s角变化。结果：所有患者均获得随访，随访时间6～18个月，平均12．6个月。术后患者局部疼痛症状缓解，椎体高度恢复良好，未发生神经损伤症状，2例患者出现骨水泥渗漏。两组手术时间有统计学意义（P〉0．05），PKP组手术时间较PVP组长。两组手术前后ODI和VAS评分比较，差异有统计学意义（P〈0．05）。PKP组术前、术后及末次随访的椎体高度恢复、Cobb’s角与PVP组比较，差异有统计学意义（P〈0．05）。PVP组术后6个月与末次随访的椎体前缘高度及Cobb’s角比较差异有统计学意义（P〈0．05）。结论：两组手术均能有效改善患者局部疼痛症状，PKP术相对于PVP术能更有效地矫正畸形、维持伤椎高度搜恢复脊柱稳定。

OBJECTIVE ： To compare the efficacy of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） in the treatment of middle -aged osteoporotic vertebral compression fracture. METHODS： From February in 2011 to January in 2014 42 patients with osteoporotic vertebral compression fracture were treated with PVP and PKP. PVP group had 23 cases including 10 males and 13 females. PKP group had 19 cases including 8 males and 11 females. The efficacy of Visual Analog Scale, Oswestry Dis- ability Index, the height of anterior injured vertebral border and Cobb angle before and after operation were evaluated. RESULTS ： All the patients were followed - up and the duration ranged from 6 to 18 months, with an average of 12. 6 months. The local pain released, nerve damage symptoms did not occur and 2 patients occurred cement leakage. There was significantly difference in the height of anterior vertebral border and Cobb angle in PVP group and PKP group （ P 〈 0. 05 ）. There was significant difference in the height of anterior vertebral border and Cobb angle between 6 months and the last follow - up after procedures in PVP group （ P 〈 0. 05 ）. CONCLUSION： Both PVP and PKP procedures can release local pain. PKP has better effect than PVP in improving Cobb angle and vertebral body height.