经皮椎体后凸成形术与保守治疗在老年骨质疏松性胸腰椎压缩性骨折中的临床效果比较

Comparison of the clinical effects of percutaneous kyphoplasty and conservative treatment in elderly patients with osteoporotic thoracolumbar vertebral compression fracture

目的比较分析经皮椎体后凸成形术与保守治疗在老年骨质疏松性胸腰椎压缩性骨折患者治疗中的临床效果。方法将88例老年骨质疏松性胸腰椎压缩性骨折患者随机分为观察组与对照组,各44例。观察组行经皮椎体后凸成形术治疗,对照组行保守治疗。比较两组疗效。结果治疗后1周、3个月,两组患者的VAS及ODI评分均降低,且观察组低于对照组(P<0.05)。治疗后3个月,两组患者的椎体压缩率、骨钙素、骨密度、CTX-1水平均降低,脊柱后凸角均减小,但观察组骨钙素及骨密度高于对照组,椎体压缩率、CTX-1水平低于对照组,脊柱后凸角小于对照组(P<0.05)。观察组患者的临床治疗优良率高于对照组(P<0.05)。结论经皮椎体后凸成形术治疗老年骨质疏松性胸腰椎压缩性骨折的效果确切,可有效缓解患者疼痛,改善伤椎功能及骨相关指标。

Objective To compare and analyze the clinical effects of percutaneous kyphoplasty and conservative treatment in elderly patients with osteoporotic thoracolumbar vertebral compression fracture.Methods A total of 88 elderly patients with osteoporotic thoracolumbar vertebral compression fracture were randomly divided into observation group and control group,with 44 cases in each group.The observation group received percutaneous kyphoplasty treatment,and the control group received conservative treatment.The treatment efficacy of the two groups were compared.Results At one week and three months after treatment,the VAS and ODI scores of the two groups significantly decreased,and those in the observation group were lower than the control group(P<0.05).At three months after treatment,the vertebral compression rates,the osteocalcin,bone density and CTX-1 levels,kyphosis angle in the two groups decreased,but the osteocalcin and bone density in the observation group were higher than those in the control group,and the vertebral compression rates,the CTX-1 level were lower than those in the control group,kyphosis angle was less than that in the control group(P<0.05).The excellent and good rate of treatment in the observation group was higher than that in the control group(P<0.05).Conclusion Percutaneous kyphoplasty has a significant effect in the treatment of elderly patients with osteoporotic thoracolumbar vertebral compression fracture,it can effectively relieve the pain of patients,improve the function of injured vertebrae and the bone related indexes.