PVP与PKP治疗老年骨质疏松性椎体压缩骨折的临床分析

Clinical Analysis of PVP and PKP in Treating Elderly Patients with Osteoporotic Vertebral Compression Fracture

目的研究老年骨质疏松性椎体压缩骨折患者采用经皮椎体成形术(Percutaneous vertebro plasty,PVP)与经皮椎体后凸成形术(Percutaneous kyphoplasty,PKP)的治疗效果。方法通过回顾性分析2014年4月至2017年4月期间我科收治的88例老年骨质疏松性椎体压缩骨折患者,其中44例患者采用PVP术式治疗作为实验组,另外44例患者采用PKP术式治疗作为对照组。观察两组患者手术前后的VAS、ODI评分、椎体前缘高度变化和Cobb角,并分析并发症情况。结果PVP、PKP组治疗总有效率分别为93.18%、95.45%,两组对比差异无统计学意义(P>0.05)。术前两组患者VAS、ODI、椎体前缘高度以及Cobb角差异无统计学意义(P>0.05);术后PKP组VAS、ODI、椎体前缘高度以及Cobb角均优于对照组(P<0.05)。PKP组并发症发生率仅为4.55%,明显低于PVP的15.91%(P<0.05)。结论 PKP治疗老年患者骨质疏松性椎体压缩骨折患者效果确切,安全性高,可以有效改善椎体高度,迅速减轻疼痛,恢复椎体后凸角度,值得在临床工作中推广应用。

Objective To study the clinical effects of percutaneous vertebroplasty （PVP） and percutaneous kyphoplasty （PKP） in elderly patients with osteoporotie vertebral compression fracture. Methods A retrospective analysis was conducted about 88 elderly patients with osteoporotic vertebral compression tYacture （OVCF） treated in our department from April 2014 to April 2017. The cases were randomly divided into the experiment group （44 cases） treated by PKP and the control group （44 cases） treated by PVP. The scores of VAS and ODI, height changes of anterior vertebral body and Cobb Angle of the two groups were observed before and after op- eration. And the complications were analyzed. Results The total effective rates for PVP group and PKP group were 93. 18% and 95.45% respectively, with no differences （P〉0. 05）. Before surgery, the scores of VAS and ODI, height of anterior vertebral body and Cobb Angle of the two groups were not significantly different （P〉0. 05 ） ; After surgery, height of anterior vertebral body and Cobb Angle of the experiment group were all better than those of the control group （P〈0. 05）. The incidence rate of complications of PKP group （4. 55% ） was lower than that of PVP group （ 15.91% ） （ P〈0. 05 ）. Conclusion PKP has a better effect in treating osteopo- rotic vertebral compression fracture in elderly patients with high safety. It can effectively improve the vertebral height, relieve the pain and recover the posterior vertebral angle. Therefore, it is worthy of clinical application and promotion.