椎体成形术与椎体后凸成形术治疗老年骨质疏松性胸腰椎骨折的临床分析

Vertebroplasty versus kyphoplasty in treatment of osteoporotic thoracolumbar fractures in elderly patients

目的评价经皮椎体成形术（PVP）与经皮椎体后凸成形术（PercutaneousKyphoplasty，PKP）治疗老年骨质疏松性胸腰椎骨折（OPTF）的临床效果。方法选择2012年2月至2016年8月期间本院收治的老年骨质疏松性胸腰椎骨折患者98例，按照数字表法随机分为两组，对照组49例给予PVP治疗；观察组49例给予PKP治疗，并比较两组的临床效果。结果两组治疗后VAS评分与治疗前比较（分别t=-19．7795、-19．2184，均P〈0．05）；两组治疗后椎体前缘高度和后凸Cobb角度较治疗前均有显著改善（均P〈0．05），但观察组椎体前缘高度和后凸Cobb角度改善程度均优于对照组（分别t=7．1656、-7．5574，均P〈0．05）；观察组并发症发生率为6．12％，明显低于对照组的18．37％（χ2=3．4186，P〈0．05）；观察组患者相邻椎体骨折发生率为8．16％，与对照组的10．20％比较，差异无统计学意义（χ2=0．1223，P〉0．05）。结论PVP和PKP均能安全、可靠并显著地缓解骨质疏松性胸腰椎骨折患者的疼痛，而PKP在改善椎体高度、恢复椎体形态、降低骨水泥渗漏上优于PVP。

Objective To observe the clinical effect of percutaneous vertebroplasty （PVP） versus percutaneous kyphoplasty （PKP） in the treatment of osteoporotic thoracolumbar fractures （OPTF） in elderly patients. Methods 98 elderly patients with OPTF treated at our hospital from February, 2012 to August, 2016 were selected and were randomly divided into a control group and an observation group, 49 for each group. The control group were treated by PVP and the obervatin group PKP. The clinical effects were compared between these two groups. Results The VAS scores were better after than before the treatment in both groups （t=-19.779 5, -19.218 4, both P 〈 0.05）. The anterior vertebral height and kyphosis Cobb angles were better after than before the treatment in both groups （all P 〈 0.05）. The anterior vertebral height and kyphosis Cobb angles were better in the observation group than in the control group after the treatment （t=-7.1656, -7.5574, both P 〈 0.05）. The incidence of complications was 6.12% in the observation group and was 18.37% in the control group （χ2=3.418 6, P 〈 0.05）. The incidence of adjacent vertebral fractures was 8.16% in the observation group and was 10.20% in the control group （χ 2=0.122 3, P 〉 0.05）. Conclusions PVP and PKP in the treatment of patients with OPTF both are safe and can reliably and effectively to relieve the patients＇ pain, but PKP is more effective in improving vertebral height, restoring vertebral morphology, and reducing bone cement leakage.