PVP术与非手术治疗椎体骨折后邻近椎体骨折临床治疗效果观察

Clinical observation and comparison of PVP and non-operative treatment of adjacent vertebral fracture aftervertebral fracture

目的:研究PVP术与非手术治疗椎体骨折后邻近椎体骨折的危险因素。方法:2018年8月-2019年5月收治老年骨质疏松性椎体骨折患者70例,按不同治疗方式分为两组。A组接受PVP术治疗;B组接受非手术治疗。比较两组疼痛(VAS)评分、椎体高度、骨密度及邻近椎体骨折发生率。结果:A组出现骨水泥间隙漏7例(17.50%),均无并发症发生。A组治疗1周后VAS评分低于B组,差异有统计学意义(P<0.05);A组治疗1周、1年后椎体高度及骨密度水平均优于B组,差异有统计学意义(P<0.05)。A组治疗1年后邻近椎体骨折发生率显著高于B组,差异有统计学意义(P<0.05)。结论:PVP术治疗老年骨质疏松性椎体骨折患者的效果更好,但邻近椎体骨折发生率较高,可能与患者骨密度、邻近椎体骨水泥强度、生活习惯等因素有关。

Objective:To study risk factors of PVP surgery and non-surgical treatment on adjacent vertebral fracture after vertebral fracture.Methods:From August 2018 to May 2019,70 cases of elderly patients with osteoporotic vertebral fracture were enrolled,they were divided into two groups according to different treatment methods.A group received PVP surgery.B group received non-surgical treatment.The VAS scores,vertebral height,bone mineral density and the incidence of adjacent vertebral fractures between the two groups were compared.Results:There were 7 cases(17.50%)of leakage of bone cement in A group,no complications happened.The VAS score in A group was lower than B group after 1 week of treatment,the difference was statistically significant(P<0.05).The vertebral height and bone mineral density in A group were better than those in B group after 1 week of treatment and 1 year of treatment,the differences were statistically significant(P<0.05).The incidence of adjacent vertebral fractures in A group was significantly higher than that in B group after one year of treatment,the difference was statistically significant(P<0.05).Conclusion:PVP surgery is more effective in the treatment of elderly patients with osteoporotic vertebral fracture.The incidence of adjacent vertebral fracture is high,it may be related to bone mineral density,cement strength of adjacent vertebral body,living habits and so on.