PKP治疗老年骨质疏松性椎体压缩骨折的疗效评价

Clinical effects of percutanous kyphoplasty in treatment of osteoporotic vertebral compression fractures in old people

目的评价经皮椎体后凸成形术（PKP）治疗老年骨质疏松性椎体压缩骨折的有效性和安全性。方法回顾性分析自2014-01—2015-12采用PKP治疗的31例老年骨质疏松性椎体压缩骨折。比较术前、术后3 d、术后6个月疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）。比较术前、术后3 d、末次随访时的伤椎椎体前缘高度。结果本组所有患者均获得随访,随访时间6~12个月,平均7.6个月。术后3 d所有患者VAS评分、ODI指数较术前明显降低;术后6个月随访时患者VAS评分、ODI指数较术前及术后3 d进一步降低,差异均有统计学意义（P〈0.05）。术后3 d的伤椎椎体前缘高度较术前明显增加,差异有统计学意义（t=-12.243,P〈0.001）;末次随访时伤椎椎体前缘高度与术后3 d比较差异无统计学意义（t=1.898,P=0.067）。结论 PKP不仅早期即可缓解老年骨质疏松性椎体压缩骨折患者的疼痛,提高患者生活质量,明显恢复伤椎高度,而且长期随访观察到PKP也可进一步患解疼痛,较好地维持椎体高度。

Objective To investigate the safety and efficacy of percutanous kyphoplasty（PKP） in the treatment of osteoporotic vertebral compression fractures in old people. Methods Percutanous kyphoplasty procedures were performed in 31 patients with osteoporotic vertebral compression fractures in our hospital from Jan. 2014 to Dec. 2015. VAS and ODI were used to indicate pain relief and the functional improvement in patients treated with percutanous kyphoplasty, respectively. All patients＂ vertebra height was recorded before and after operation. Results All enrolled patients were followed, and final follow-up was performed at mean 7.6 months （range： 6-12 months）. Three days after operation, patients had less VAS and ODI scores compared with preoperative values. At 6-month fallow-up, all patients showed much less VAS and ODI scores compared with preoperative and 3 days post-operative values, respectively （P 〈0.05）. The height of fracture vertebra at 3 days after operation was significantly higher than that before operation （t =1.898, P =0.067）. However, there was no difference in the height of fracture vertebra between 3 days after operation and 6-month follow-up （t =1.898, P =0.067）. Conclusion Percutanous kyphoplasty is an effective treatment of osteoporotic vertebral compression fractures in terms of pain relief, durable reduction of deformity and improvement of quality of patients＇ life.