体位复位结合经皮椎体成形术与经皮椎体后凸成形术治疗骨质疏松性椎体压缩骨折疗效比较

Comparison effect of hyperextension postural reduction combined with percutaneous vertebroplasty and percutaneous kyphoplasty in the treatment of osteoporotic vertebral compres-sion fractures

目的比较体位复位结合经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗老年骨质疏松性椎体压缩骨折(OVCF)的临床疗效。方法将70例OVCF患者随机分为两组,每组35例,A组行体位复位结合PVP治疗,B组行PKP治疗。比较两组患者术后腰痛VAS评分、伤椎前缘高度、后凸Cobb角变化情况。结果患者均获得随访,时间6~12个月。两组术后3 d及3、6个月VAS评分、Cobb角度数均明显低于术前,椎体前缘高度均显著高于术前,差异均有统计学意义(P<0.05);两组间术后各项指标比较差异均无统计学意义(P>0.05)。结论体位复位法结合PVP与PKP治疗OVCF的临床疗效相当,体位复位结合PVP具有治疗费用低的优点。

Objective To compare the effect of hyperextension postural reduction combined with percutaneous vertebroplasty（PVP） and percutaneous kyphoplasty （PKP） in the treatment of elderly osteoporotic vertebral compression fractures （OVCF）. Methods The 70 cases of OVCF patients were randomly divided into two groups, each group of 35 cases. Group A was treated with the hyperextension postural reduction before PVP operation and group B was trea- ted with PKP. The low back pain VAS, height of vertebrae, and kyphotic Cobb angle were compared between two groups after surgery. Results All patients were followed up for 6 - 12 months. At postoperative 3 d, 3,6 months, the VAS and Cobb angle of the two groups were significantly lower than those of the preoperative level, and the anteri- or vertebral height was significantly higher than that before operation, the differences were statistically significant（ P 〈 0. 05）. There was no significant difference of postoperative indicators between the two groups （P 〉 0. 05）. Conclu- slons Hyperextension postural reduction combined with PVP and PKP in the treatment of elderly OVCF have the same clinical efficacy, the hyperextension postural reduction combined with PVP has the advantage of lower cost of treatment.