单侧PVP治疗老年骨质疏松椎体压缩性骨折的临床研究

The Clinical Study on PVP Surgery in Elderly Patients With Osteoporotic Vertebral Compression Fractures

目的探讨单侧经皮椎体成形术(PVP)治疗老年骨质疏松椎体压缩性骨折(OVCF)患者的临床效果。方法将110例老年OVCF患者随机分为PVP组与开放组,各55例,分别于手术前后以VAS评分评估患者疼痛,以ODI评价患者功能障碍,记录伤椎后凸Cobb角、伤椎前缘高度,对比两组出院时和出院后6个月优良率。结果 PVP组出院时和出院后6月优良率高于开放组(P<0.05);与开放组比,PVP组术中出血量增加,而手术时间、X线照射时间、住院时间缩短(P<0.01);治疗7 d、1个月、6个月PVP组伤椎增加高度、伤椎中部高度、VAS评分、ODI评分低于开放组(P<0.05或P<0.01)。结论 PVP术能有效提高老年OVCF患者治疗效果,减轻术后疼痛,改善其胸腰椎功能。

Objective To study the effect of percutaneous vertebroplasty（PVP） in the treatment of elderly patients with osteoporotic vertebral compression fractures（OVCF）. Methods 110 OVCF patients were randomly divided into open surgery group（n=55） and PVP surgery（n=55）. The patient＇s pain was assessed by VAS score before and after the operation, and the patient＇s dysfunction was evaluated by ODI. The angle of kyphosis, the angle of Cobb and the anterior edge of the injured vertebra were recorded. The excellent rates of the two groups were compared between the 6 groups at discharge and after discharge. ResultsThe excellent rate of PVP group in discharged and after 6 months were higher than that of open surgery group（P〈0.05）. The intraoperative blood loss, operation time, fluoroscopy time and hospitalization time of PVP group were less than that of open group（P〈0.01）. 7 d, 1 and 6 months in the PVP group, the height of the injured vertebrae and vertebrae, VAS and ODI scores were lower than that of open group（P〈0.05 or P〈0.01）. Conclusion PVP technique can improve the therapeutic effect in OVCF elderly patients, can effectively reduce postoperative pain, improve function in patients with thoracolumbar.