球囊扩张椎体成形术治疗急性与亚急性期骨质疏松椎体压缩骨折的疗效对比

Clinical efficacy of percutaneous kyphoplasty in the treatment of acute and subacute phase of osteoporotic vertebral compression fractures

目的比较经皮穿刺球囊扩张椎体后凸成形术治疗急性与亚急性期椎体压缩骨折椎体的疗效。方法回顾性收集2014年1月至2014年6月间北京市中国人民解放军306医院骨科行球囊扩张椎体后凸成形术治疗的骨质疏松性椎体压缩骨折患者43例。其中男6例(14%),女37例(86%)。全部患者分为急性期组21例(受伤2 w内)和亚急性期组22例(受伤2 w^2个月)。比较手术前后两组患者的VAS评分及椎体高度变化情况。结果 43例患者均获得满意随访,随访时间(9.1±1.7)个月。与术前相比,术后两组患者的VAS评分均明显降低,差异有统计学意义(t=3.262,t=3.262,P<0.05),但组间比较无统计学差异。与术前相比,术后两组患者的椎体高度均明显增大,差异有统计学意义(t=-4.894,t=-4.795,P<0.05)。而组间手术前后的椎体高度差值比较[急性期组:(4.12±0.23)mm;亚急性期组:(3.96±0.35)mm],无统计学差异(t=0.325,P=0.351)。结论经皮穿刺球囊扩张椎体后凸成形术可有效缓解急性与亚急性期OVCF患者的疼痛,两期患者的应用效果无差异。

Objective To explore the clinical efficacy of percutaneous kyphoplasty in the treatment of acute and sub-acute phase of osteoporotic vertebral compression fractures.Methods A retrospective analysis was performed in43cases of osteoporotic vertebral compression fractures who underwent PKP in our hospital from January2014to June2014.Data of43cases were collected including6males(14%)and37females(86%),patients were divided into acute group(21cases,injured within2weeks),and sub-acute group(22patients,had injured for2w-2m).Comparison of the change of VAS and pre-and post-operative vertebral heights between two groups were done.Results All patients had well followed-up with an average of9.1±1.7months.There was no statistical significance of preoperative VAS between two groups,while it was decreased postoperatively of both groups compared to the baseline,differences were statistically significant(t=3.262,t=3.262,P<0.05).The postoperative vertebral heights were significantly statistical different compare to the preoperative in both groups(t=-4.894,t=-4.795,P<0.05),and acute group was higher than the sub-acute group.While the intergroup comparison of vertebral heights before and after PKP had no statistical significance(acute group:4.12±0.23mm;sub-acute group:3.96±0.35mm,t=0.325,P=0.351).Conclusion PKP can effectively reduce the pain of patients with acute or sub-acute OVCF,but no differences were observed.