保守治疗、PVP及PKP术治疗胸腰椎压缩性骨折的效果比较

Comparison of the effects of conservative treatment,PVP and PKP in the treatment of thoracolumbar vertebral compression fractures

目的比较保守治疗、经皮椎体成形术(PVP)及经皮椎体后凸成形术(PKP)治疗胸腰椎压缩性骨折的效果。方法将147例胸腰椎压缩性骨折患者根据治疗方式分为保守治疗组、PVP组及PKP组,各49例。比较三组临床效果。结果术后3个月,PKP组的JOA评分及椎体前缘高度高于PVP组与保守治疗组,且PVP组高于保守治疗组(P<0.05)。PKP组的ODI评分低于PVP组与保守治疗组,且PVP组低于保守治疗组(P<0.05)。PKP组的Cobb角小于PVP组与保守治疗组,且PVP组小于保守治疗组(P<0.05)。PKP组的再发骨折率低于PVP组与保守治疗组(P<0.05)。结论与PVP及保守治疗相比,PKP术治疗胸腰椎压缩性骨折的效果显著,可有效改善腰椎功能,加快椎体前缘高度恢复,降低骨折再发风险。

Objective To compare the effects of conservative treatment,percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)on thoracolumbar vertebral compression fractures.Methods A total of 147 patients with thoracolumbar vertebral compression fractures were divided into conservative treatment group,PVP group and PKP group by the treatment methods,with 49 cases in each group.The clinical effects of the three groups were compared.Results Three months after operation,JOA score and anterior vertebral height of the PKP group were higher than those of the PVP group and the conservative treatment group,and those of the PVP group were higher than the conservative treatment group(P<0.05).The ODI score of the PKP group was lower than that of the PVP group and the conservative treatment group,and that of the PVP group was lower than the conservative treatment group(P<0.05).The Cobb angle of the PKP group was smaller than that of the PVP group and the conservative treatment group,and that of the PVP group was smaller than the conservative treatment group(P<0.05).The fracture recurrence rate of the PKP group was lower than that of the PVP group and the conservative treatment group(P<0.05).Conclusion Compared with PVP and conservative treatment,PKP in the treatment of thoracolumbar compression fractures has significant effect,which can effectively improve the lumbar function,accelerate the recovery of anterior vertebral height,and reduce the risk of fracture recurrence.