经皮椎体后凸成形术联合骨化三醇和钙剂治疗OVCF的临床研究

Clinical Efficacy of Percutaneous Kyphoplasty Combined with Calcitriol and Calcium in the Treatment of Osteoporotic Vertebral Compression Fractures

目的探讨经皮椎体后凸成形术(percutaneous kyphoplasty,PKP)联合骨化三醇和钙剂治疗骨质疏松性椎体压缩性骨折(osteoporotic vertebral compression fracture,OVCF)的临床疗效。方法选取苏州大学附属第一医院2019年1月-2020年1月收治的OVCF住院患者40例进行分析。将40例患者用随机数表法分为对照组和治疗组各20例,对照组患者采用PKP手术治疗,治疗组患者在PKP手术治疗的基础上联合使用骨化三醇和钙剂。分别比较两组OVCF患者手术前、手术后1个月及手术后6个月的疼痛视觉模拟评分量表(visual analogue scale,VAS)评分、Oswestry功能障碍指数(Oswestry disability index,ODI)评分、伤椎椎体前缘高度、Cobb角及骨密度水平。结果两组患者手术前的VAS评分、ODI评分、伤椎椎体前缘高度、Cobb角及骨密度水平差异无统计学意义(P>0.05)。两组患者手术后的VAS评分、ODI评分、伤椎椎体前缘高度、Cobb角均显著优于相应手术前水平。手术后1个月和6个月随访时,治疗组患者VAS评分、ODI评分、伤椎椎体前缘高度、Cobb角和骨密度值均显著优于对照组,差异具有统计学意义(P<0.05)。结论PKP手术治疗OVCF患者,可以显著缓解患者疼痛症状,纠正椎体高度丢失和后凸畸形,改善患者脊柱功能,提高患者生活质量。而PKP手术联合骨化三醇和钙剂治疗的疗效明显好于单纯PKP手术,值得临床推广应用。

Objective To explore the clinical efficacy of percutaneous kyphoplasty(PKP)combined with calcitriol and calcium in the treatment of osteoporotic vertebral compression fractures(OVCF).Methods 40 inpatients with OVCF admitted to the First Affiliated Hospital of Soochow University from January 2019 to January 2020 were selected for analysis.The 40 patients were divided into a control group and a treatment group with 20 cases each by a random number table.The patients in the control group were treated with PKP surgery,and the patients in the treatment group were treated with calcitriol and calcium on the basis of PKP surgery.The pain visual analogue scale(VAS)scores,Oswestry disability index(ODI)scores,the height of the anterior edge of the vertebral body,the Cobb's angle and the level of bone mineral density of the two groups of OVCF patients before surgery,1 and 6 months after surgery were recorded and compared.Results There was no significant difference in the VAS score,ODI score,the height of the anterior edge of the injured vertebral body,Cobb's angle and bone mineral density between the two groups before surgery(P>0.05).The VAS score,ODI score,the height of the anterior edge of the injured vertebral body,and the Cobb's angle of the two groups of patients after surgery were significantly better than those before the operation.At 1 month and 6 months after surgery,the VAS score,ODI score,the height of the anterior edge of the injured vertebral body,the Cobb angle and the bone mineral density of the patients in the treatment group were significantly better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion PKP treatment of OVCF patients can significantly relieve the pains of the patients,correct the loss of vertebral body height and kyphosis,improve the patient's spinal function,and improve the quality of life of the patients.The curative effect of PKP surgery combined with calcitriol and calcium treatment is significantly better than that of PKP surgery alone,and it is worthy of clinical application.