骨质疏松性椎体骨折患者应用椎体后凸成形术与椎体成形术治疗效果比较

Comparison of the Kyphoplasty and Vertebroplasty Treatment for Osteoporotic Vertebral Fractures

目的比较经皮椎体后凸成形术和椎体成形术治疗骨质疏松性椎体骨折患者的临床疗效。方法回顾性分析我院2013年1月~2015年6月82例骨质疏松性椎体骨折患者临床治疗情况,其中41以经皮椎体后凸成形术治疗者为观察组,另41例患者采用经皮椎体成形术治疗,为对照组。采用视觉模拟评分法（VAS）评价患者治疗前后疼痛情况,应用侧位X线片检测患者Cobb角变化。统计两组患者临床疗效、手术时间、总住院时间及骨水泥注射量;记录两组患者骨水泥渗漏人数。结果治疗后,两组患者VAS评分较治疗前显著下降,且观察组明显优于对照组,P〈0.05;两组患者Cobb角均明显下降,但观察组明显优于对照组,P〈0.05。观察组患者治疗有效率为92.7%,与对照组95.1%比较,P〉0.05;观察组手术时间和总住院时间及骨水泥注射量均明显少（短）于对照组,P〈0.05;观察组骨水泥渗漏发生率为12.2%,明显低于对照组46.3%,P〈0.05。结论相比经皮椎体成形术来说,应用经皮椎体后凸成形术治疗骨质疏松性椎体骨折患者具有更好的疗效,因此更值得推广应用。

Objective To investigate the clinical efficacy of osteoporotic vertebral fractures in patients with percutaneous kyphoplasty treatment. Methods A retrospective analysis of our hospital in January 2013 to June 2015 was carried out in 82 cases of osteoporotic vertebral fractures. There were 41 patients un- derwent percutaneous kyphoplasty treatment （ observation group） , and another 41 cases treated with percuta- neous vertebroplasty treatment （control group ）. The visual analog scale （VAS） before and after operation was evaluated, and the Cobb angle changes were measured on the lateral X-ray image. The clinical efficacy of the two groups were compared on the operative time, hospital stay and the amount of bone cement injection, and the number of bone cement leakage. Results After operation, the VAS scores of the both two groups decreased significantly, and the degree of decline in the observation group was more obvious than the control group（P 〈0.05）. The Cobb angle of the two groups was significantly decreased, but the degree of decline in the observation group wag more obvious than the control group （ P 〈 0.05 ）. The effective rate of observation group was 92.7% , which was not different with 95.1% of the control group （P 〉 0.05 ）. There were signifi- cant differences between the two groups in operating time , the total hospital stay and bone cement injection vol- ume, and the observation group was better than the control group （ P 〈 0.05 ） . The bone cement leakage rate of the observation group was 12.2%, which was significantly lower than 46.3% of the control group （ P 〈 0.05 ）. Conclusion Compared to percutaneous vertebroplasty, the percutaneous kyphoplasty has better efficacy for os- teoporotic vertebral fracture patients, and therefore is more worthy of promotion and application.