过伸位经皮椎体成形术与球囊扩张椎体后凸成形术治疗老年性骨质疏松椎体骨折的疗效观察

Efficacy of hyperextension reduction percutaneous vertebroplasty and percutaneous kyphoplasty in treatment of patients with osteoporotic vertebral compression fractures

目的比较过伸位经皮椎体成形术(hyperextension reduction percutaneous vertebroplasty,HRPVP)与球囊扩张椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗老年骨质疏松性椎体压缩骨折(osteoporotic vertebral compression fracture,OVCF)的临床效果。方法选择2012年10月至2014年6月湖北医药学院附属人民医院脊柱外科收治的OVCF患者97例(119椎),其中男25例,女72例;平均年龄为(73.40±5.16)岁。本组患者随机分为两组,HRPVP组52例,采用HRPVP治疗;PKP组45例,采用PKP治疗。分别于术前1 d、术后2 d及术后第3、6个月采用疼痛视觉模拟量表(visual analogue scales,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)、椎体高度、Cobb角等临床和影像学指标评价两组患者的治疗效果。结果两组患者术后腰背部疼痛症状均明显缓解。术后2 d,术后3、6个月的腰背痛VAS评分、ODI、椎体高度、Cobb角等均优于术前,差异均有统计学意义(均P<0.05),但同一时间点两组间比较差异均无统计学意义(均P>0.05)。结论 HRPVP与PKP治疗OVCF,两种方法都能够迅速缓解腰背部疼痛、很好地矫正后凸畸形,而HRPVP操作简单易行,实用性强,值得推广。

Objective To compare the effect of hyperextension reduction percutaneous vertebroplasty （HRPVP） and percutaneous kyphoplasty （PKP） in the treatment of osteoporotic vertebral compression fractures. Methods Between October 2012 and June 2014, 97 patients （119 vertebrae） with osteoporotic vertebral compression fractures were collected. There were 25 males and 72 female with mean age of （73.40±5.16） years old. The patients were randomly divided into HRPVP group （52 cases） and PKP group （45 cases）. The visual analogue scale scores （VAS）, Oswestry disability index （ODI）, vertebral height, Cobb angle and other clinical and imaging examinations were used to assess the effect of the treatment at 1st day of preoperation, and 2nd day and 3rd month, 6th month of postoperation. Results Two groups of patients with back pain were signifi- cantly relieved. The VAS, ODI, vertebral height and Cobb angle at 2nd day and 3rd month, 6th month of postoperation were significantly better than those before operation （P 〈 0.05 for all）. There was no significant difference between the two groups at the same time （P 〉 0.05 for all）. Conclusion HRPVP and PKP for the treatment of OVCF can quickly relieve the back pain, and are good corrections of the kyphosis, but the HRPVP operation is simple, practical, and worthy of promotion.