骨质疏松性胸腰椎压缩骨折PKP术后伤椎高度与疗效的相关性分析

Correlation analysis of vertebral height and curative effect in patients with osteoporotic thoracolumbar compression fractures after PKP

目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)治疗骨质疏松性胸腰椎压缩骨折(osteoporosis vertebral compression fractures,OVCF)术后,伤椎高度的恢复情况是否对疗效产生明显影响。方法自2013-06-2014-06采用PKP技术治疗OVCF患者62例,于术后3 d进行伤椎高度恢复比的统计,总体平均值为(69.3±7.2)%,其中,高于平均值者共43例,作为A组;低于平均值者19例,作为B组。对两组患者的相关指标进行比较。结果术后两组患者VAS评分、ODI指数和SF-36量表、Cobb角等指标均有显著改善(P<0.05),但组间差异无统计学意义(P>0.05);62例术后再发其他椎体骨折11例(17.7%),其中A组8例,发生率为18.6%;B组3例,发生率为15.8%。两组发生率对比,差异无统计学意义(P>0.05)。结论 PKP手术治疗OVCF患者可取得显著疗效,但术后伤椎高度的恢复程度与患者症状缓解效果、其他椎体再发骨折之间并无明确相关性,因此,PKP术中不必过于追求椎体高度的恢复。

Objective To investigate the influence of recovery of vertebral height on the treatment effect in patients with osteoporosis vertebral compression fracture(OVCF)after percutaneous kyphoplasty(PKP).Methods From June 2013 to June 2014,62 patients with OVCF treated by PKP treatment were collected.At postoperative 3 days,the recovery of injured vertebral height ratio was analyzed,the average value was(69.3±7.2)%,43 cases with the ratio higher than the average value were selected as A group,19 cases with the ratio lower than the average value were selected as B group.The relevant indicators were compared between the two groups.Results The VAS score,ODI index,SF-36 scale and Cobb angle of two groups were improved significantly after operation(P<0.05),but the difference between the two groups was not significant(P>0.05).Of 62 cases,postoperative recurrence of other vertebral fractures occurred in 11 cases(17.7%),including 8 cases of A group,the incidence rate was 18.6%;3 cases in B group,the incidence rate was 15.8%.There was no significant difference between the two groups(P>0.05).Conclusion PKP in the treatment of patients with OVCF can achieve significant effect,but there is no significant correlation among the recovery of postoperative vertebral height,alleviation of the patients’symptoms,and the incidence of other vertebral fractures.Therefore,the restoration of vertebral height is not needed to pursue during the operation of PKP.