手术时机对骨质疏松性椎体压缩骨折疗效的影响

Effect of operation timing on the therapeutic effect of osteoporotic vertebral compression fracture

目的探讨经皮椎体后凸成形术(PKP)手术时机对骨质疏松性椎体压缩骨折(OVCF)疗效的影响。方法将92例行PKP治疗的OVCF患者按伤后至手术时间不同分为A组(伤后至手术时间≤7 d,45例)和B组(伤后至手术时间8~21 d,47例)。比较两组腰背部疼痛VAS评分、椎体前缘高度比、椎体后凸Cobb角及术后骨水泥渗漏率。结果患者均获得随访,时间9~24个月。术后1周、1个月VAS评分A组均低于B组(P<0.05),术后6个月两组比较差异无统计学意义(P>0.05)。术后1周椎体前缘高度比、Cobb角A组均优于B组,术后6个月两组比较差异均无统计学意义(P>0.05)。骨水泥渗漏率A组低于B组(P<0.05)。结论OVCF患者伤后早期行PKP可更好地缓解腰背部疼痛,促进骨折生理结构恢复,降低手术相关不良风险。

Objective To investigate the effect of percutaneous kyphoplasty(PKP)operation timing on the therapeutic effect of osteoporotic vertebral compression fracture(OVCF).Methods The 92 OVCFs patients treated with PKP were divided into group A(45 cases within 7 d after fracture)and group B(47 cases from 8 to 21 d after fracture)according to the time from injury to operation.The VAS of lower back,the height ratio of the anterior edge of vertebrae,the kyphotic Cobb angle of the vertebral body,and the incidence rate of cement leakage were compared between the two groups.Results All patients were followed up for 9~24 months.At 1 week and 1 month after surg-ery,the VAS of group A was lower than that of group B(P<0.05),and there was no significant difference between the two groups at 6 months postoperation(P>0.05).The height ratio of the anterior edge of the vertebrae and Cobb angle in group A were better than those in group B at 1 week after operation.There was no significant difference between the two groups at 6 months after operation(P>0.05).Bone cement leakage rate in group A was lower than that in group B(P<0.05).Conclusions Early PKP surgery for OVCF patients can better relieve lower back pain,better promote the recovery of fracture physiological structure,and reduce the risk of surgery-related adverse effects.