PKP/PVP治疗相邻多节段胸腰椎骨折并后凸畸形疗效分析

The analysis on the therapeutic effect of PKP/PVP in the treatment of thoracolumbar fractures and posterior convex deformity

目的：探讨经皮椎体成形术（ PVP）和后凸成形术（ PKP）对相邻多节段胸腰椎骨折并后凸畸形的疼痛缓解及矫形的疗效分析，为进一步提高临床疗效提供数据支持。方法收集2014年1月至2016年5月济宁医学院附属医院脊柱外科收治的相邻多节段胸腰椎压缩性骨折患者85例，共276个椎体，随机分为PKP组33例，共97个椎体，予以PKP治疗；PVP组52例，共179个椎体，予以PKP治疗。所有患者获完整随访，比较末次随访的观察指标：VAS评分（vision analogue scale，vas）、ODI指数（oswestry disability index，ODI）、矢状位椎体Cobb角，并采用统计学软件SPSS19．0进行数据分析。结果随访9-24月，平均（12．03±2．41）月，两组间术后末次随访VAS评分、ODI指数，Cobb角比较差异有统计学意义（P＜0．05）。结论 PVP、PKP均能有效缓解老年相邻多节段骨质疏松胸腰椎压缩性骨折引起的疼痛， PKP在缓解疼痛、纠正椎体后凸畸形、恢复矢状位椎体Cobb角上远期疗效优于PVP。

Objective To explore the curative effect for elderly adjacent multi-level thoracic lumbar frac-tures and kyphosis in relieving pain and correcting deformity by percutaneous vertebroplasty（ PVP） and per-cutaneous kyphoplasty （ PKP） ,which further improves the clinical efficacy with the basic data support.Meth-ods From January,2014 to May,2016,85 cases diagnosed with the adjacent multi-level thoracic lumbar com-pression fractures,were collected in the Affiliated Hospital of Jining Medical University,who had a total of 276 vertebraes.It was randomly divided into PKP group （33 cases） treated with the PKP,a total of 97 verte-braes,and PVP group （52 cases） treated with the PVP,a total of 179 vertebraes.All the cases were complete-ly followed up using the VAS scores （vision analogue scale,VAS）,ODI （Oswestry disability index （ODI）,and Sagittal vertebraes Cobb angles as the observation index in the last follow-up.The data were analyzed by the use of statistical software SPSS 19.0.Results 9-24 months were followed up and the average months were 12.03 ±2.41m.Between the postoperative two groups,the observation index （VAS score,ODI index,Cobb angle） at the end of the follow-up were statistically significant difference （ P〈0.05）.Conclusion PVP and PKP were effective in the treatment of elderly adjacent multi-segment osteoporotic thoracolumbar vertebral compression fractures to relieve pain.To the long-term efficacy,PKP is better than PVP in the relief of pain and recovery of sagittal vertebraes Cobb angle.