单侧PVP术后致对侧发生骨折的临床分析

Clinical analysis of unilateral PVP operation induced contralateral fracture

目的探讨老年人脊柱压缩性骨折单侧PVP术后对侧发生椎体骨折的临床特点及治疗方法。方法回顾性分析2011-05-2014-05在我院经单侧椎体成形术(PVP)治疗脊柱压缩性骨折共286例,其中再发对侧椎体骨折16例16椎体,10例经对侧椎弓根再次采用PVP术,6例采用卧床休息保守治疗,并行抗骨质疏松治疗。比较两组患者入院、1、3、6、12月VAS(视觉模拟疼痛)评分及再骨折情况。结果手术组术后24h疼痛明显改善,保守治疗组1月后疼痛减轻,随访3、6、12月两组VAS评分无明显差别,随访期间未再出现骨折。结论 PVP术后再次骨折后行PVP,可及时有效的缓解疼痛,保守治疗同样可有效的缓解患者症状,规律的抗骨质疏松治疗是预防再次骨折的关键。

Objective To discuss the clinical characteristics and treatment method of contratateral vertebra fracture among old patients after compression spine fracture unilateral PVP operation. Methods A retrospective analysis was made on 286 cases who had received unilateral vertebroplasty （PVP） operation in treating compression spine fracture in our hospital from May 2011 to May 2014. Among these 286 cases, contralateral vertebra fracture occurred in 16 cases and 16 centrum. 10 cases adopted PVP operation again, 6 cases adopted conventional treatment and rested in bed, and received anti-osteoporosis treatment. The hospitalization, visual analogue scale （VAS） scores at 1, 3, 6, 12 months and re-fracture condition of patients in two groups were compared and analyzed. Results For patients in the operation group, their pain relieved evidently in 24 h; for patients in the treatment group, their pain relieved in 1 month. During follow-up visits, VAS scores of two groups at 3, 6, 12 months had no evident differences. No fracture occurred during follow-up visits. Conclusion Conducting PVP operation again for treating fracture after PVP operation can efficiently relieve the pain. The conventional treatment can also efficiently release the patients＂ symptoms. Regular anti- osteoporosis treatment is the key point for preventing re-fracture.