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骨质疏松性胸腰椎压缩骨折经皮椎体后凸成形术实施时间对疗效的影响 被引量:8

The influence of timing of percutaneous kyphoplasty on curative effect in the treatment of patients with osteoporotic thoracolumbar vertebral compression fractures
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摘要 目的探讨骨质疏松性胸腰椎压缩骨折患者伤后至实施经皮椎体后凸成形术(PKP)时间对疗效的影响。方法将183例行PKP治疗骨质疏松性胸腰椎压缩骨折患者按伤后至手术时间分为3组:A组伤后1周内手术(112例),B组伤后1~3周手术(53例),C组伤后>3周手术(18例)。比较3组术中骨水泥注射量及渗漏发生率,术后12个月的VAS评分及其改善率、Cobb角变化及椎体前缘高度改善率。采用SF-36健康调查量表评价患者术后12个月的生活质量。结果术中骨水泥注射量:A组多于B、C组(P<0.01),B组多于C组(P<0.01)。骨水泥渗漏发生率:A组高于B、C组(P<0.05),B组高于C组(P<0.05)。术后12个月,VAS评分:3组均较术前显著降低(P<0.01),3组间比较差异无统计学意义(P>0.05);VAS评分改善率:A组高于B、C组(P<0.01),B、C组比较差异无统计学意义(P>0.05);Cobb角:3组与术前比较均显著减小(P<0.01),3组间比较差异无统计学意义(P>0.05);椎体前缘高度改善率:A组最高,C组最低;患者生活质量情况:8个维度得分的两两比较中,A、B组间各个维度得分比较差异均有统计学意义(P<0.05,P<0.01),B、C组间除了PF和RE维度,其他维度比较差异均有统计学意义(P<0.01),A、C组间除了RP维度,其他维度得分差异均有统计学意义(P<0.05,P<0.01)。结论骨质疏松性胸腰椎压缩骨折患者伤后1周内进行PKP临床效果显著。 Objective To investigate the influence of timing of percutaneous kyphoplasty(PKP)on curative effect in the treatment of patients with osteoporotic thoracolumbar vertebral compression fractures.Methods The 183 cases with osteoporotic thoracolumbar vertebral compression fractures were divided into 3 groups according to the time from injury to operation.The surgery time after injury of group A was within 1 week(112 cases),group B was within 1~3 weeks(53 cases),group C was>3 weeks(18 cases).The bone cement injection volume and leakage incidence rate during operation were compared among the three groups.The VAS and VAS improvement rate,changes of Cobb angle,improvement rate of anterior vertebral height were compared among the three groups.The life quality at 12 months after surgery was assessed by using the SF-36 Health Survey Scale.Results The bone cement injection volume:the group A was higher than the group B and C(P<0.01),and the group B was higher than the group C(P<0.01).The leakage incidence rate of bone cement:the group A was higher than the group B and C(P<0.05),and the group B was higher than the group C(P<0.05).At 12 months postoperation,the VAS of three groups were significantly lower than the preoperative(P<0.01),and VAS of three groups had no differences(P>0.05);the group A had the higher improvement rate of VAS than group B and C(P<0.01),and no significant difference was found between group B and C(P>0.05).The Cobb angle at 12 months after operation was significantly lower than that in the three groups before operation(P<0.01),and there was no significant difference among the three groups(P>0.05);the improvement rate of the anterior vertebral body height in the group A was the highest,group C was the lowest,and there were significant differences between every two groups in the three groups(P<0.01).At 12 months postoperatively,the life quality scores showed that there were significant differences in 8 dimensions scores between group A and B(P<0.05,P<0.01),there were significant differences between group B and C in other dimensions scores(P<0.01)except PF and RE dimensions,and there were significant differences in other dimensions scores between group A and C(P<0.05,P<0.01)except RP dimension.Conclusions The clinical effect of PKP within 1 week after injury in the treatment of patients with osteoporotic thoracolumbar vertebral compression fractures is significant.
作者 何玉泽 张新珠 HE Yu-ze;ZHANG Xin-zhu(Dept of Spine Surgery,the Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu221000,China)
出处 《临床骨科杂志》 2018年第2期144-146,共3页 Journal of Clinical Orthopaedics
关键词 胸腰椎压缩骨折 经皮后凸成形术 骨质疏松 thoracolumbar vertebral compression fractures percutaneous kyphoplasty osteoporosis
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