PKP与“五点式”支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折疗效比较

Effects Comparison of PKP and "Five-point" Support and Reduction Combined Therapy in Treating New Osteoporotic Thoracolumbar Compression Fracture

目的:观察经皮椎体后凸成形术(PKP)与"五点式"支撑复位综合疗法治疗新鲜骨质疏松性胸腰椎压缩骨折(OVCFs)在缓解疼痛、矫正脊柱后凸畸形、改善患者生活质量及邻近再骨折发生率、骨密度改善等方面的效果。方法:回顾性分析OVCFs患者74例,其中37例行PKP手术治疗(A组),37例行"五点式"支撑复位综合疗法治疗(B组),术后常规拍摄伤椎及其邻近阶段X线片,行骨密度检查,2组治疗后6、12、24个月进行随访,记录患者疼痛视觉模拟评分(VAS)、伤椎前缘高度、后凸Cobb角、Oswesty功能障碍指数(ODI)、邻近再骨折发生率、骨密度改善情况。结果:A组伤椎前缘高度恢复、后凸畸形矫正、疼痛缓解及功能活动、骨密度改善等方面均优于B组,差异有统计学意义(P<0.05)。A组与B组邻近节段发生骨折率分别为8.1%和18.9%,差异有统计学意义(P<0.05)。结论:PKP能使OVCFs患者的腰背疼痛得到有效缓解,能矫正后凸畸形,改善患者生活质量,降低邻近阶段骨折的再发生。

Objective： To observe the effects of PKP and ＂five-point＂ support and reduction combined therapy in treating OVCFs on pain relief, kythphosis malformation correction, life quality improvements of the patient, the rate of adjacent fracture recurrence, and bone density improvement. Methods： All 74 patients with OVCFs were ana- lyzed retrospectively, 37 cases （A group） were given PKP surgery, 37 cases （ B group） were given ＂five-point＂ support and reduction combined therapy, routine injury vertebra and adjacent stages of X ray were shot after surgery, bone density was examined, the patients were followed in six, twelve and 24 months after treatment in two groups, VAS, anterior height of injuried vertebra, Cobb comer of kyphosis, ODI, rate of adjacent fracture recurrence, bone density improvement were recorded. Results： Anterior height of vertebra recovery, malformation correction of kyphosis, pain relief, function activity, bone density improvement in A group were better than theses of B group, there were statistical differences （P〈 0.05）. Rate of fracture in adjacent parts were 8.1% and 18.9% in A and B group respectively, there was statistical difference （P〈0.05）. Conclusion： PKP can relieve lumbar and back pain for patients with OVCFs, correct kyphosis malformation, and improve patients＇ life quality, lower recurrence of fracture in adjacent parts.