PVP对骨质疏松性胸腰椎Ⅰ度压缩性骨折患者影像参数、Oswestry功能障碍指数及并发症的影响

Effects of PVP Treatment on Imaging Parameters,Oswestry Dysfunction Index and Complications of Patients with Osteoporotic GradeⅠThoracolumbar Compression Fractures

目的分析经皮椎体成形术(PVP)对骨质疏松性胸腰椎Ⅰ度压缩性骨折患者影像参数、Oswestry功能障碍指数(ODI)及并发症的影响。方法选择2018年5月—2021年4月收治的骨质疏松性胸腰椎Ⅰ度压缩性骨折122例,按照治疗方式分为研究组74例和对照组48例。研究组给予PVP治疗,对照组给予经皮椎体后凸成形术治疗。比较2组手术相关指标、影像参数、椎体功能、疼痛程度及并发症发生情况。结果研究组手术时间、住院时间短于对照组,骨水泥量少于对照组(P<0.01)。与术前比较,2组术后椎体中部高度均上升、Cobb角均减小,且研究组椎体中部高度低于对照组(P<0.05,P<0.01)。与术前相比,2组术后ODI评分降低、日本骨科协会评估治疗分数评分升高(P<0.05)。2组术后视觉模拟评分法(VAS)评分均低于术前,且研究组术后1 d VAS评分低于对照组(P<0.05,P<0.01)。2组并发症发生率比较差异无统计学意义(P>0.05)。结论PVP治疗骨质疏松性胸腰椎Ⅰ度压缩性骨折效果确切,可有效缩短手术时间,促进术后恢复,改善椎体功能,且能早期缓解疼痛,安全性较高。

Objective To analyze the effects of percutaneous vertebroplasty(PVP)treatment on imaging parameters,Oswestry disability index(ODI)and complications in patients with osteoporotic gradeⅠthoracolumbar compression fractures.Methods A total of 122 cases of osteoporotic gradeⅠthoracolumbar compression fractures treated from May 2018 to April 2021 were selected and divided into the research group(n=122)and the control group(n=48)according to different treatment methods.The research group was treated with PVP and the control group was treated with percutaneous kyphoplasty(PKP).The operation-related indexes,imaging parameters,vertebral function,degree of pain and complications were compared between the two groups.Results The duration of operation and length of hospital stay in the research group were shorter than those of the control group,while the amount of bone cement was less than that of the control group(P<0.01).Compared with those before operation,the height of the middle vertebral body in the two groups increased,the Cobb angle decreased,and the height of the middle vertebral body in the research group was lower than that in the control group(P<0.05,P<0.01).Compared with those before operation,ODI score decreased and Japanese Orthopaedic Association(JOA)score increased in both groups after operation(P<0.05).The postoperative visual analogue scale(VAS)scores of the two groups were lower than those before operation,and the VAS scores of the research group were lower than those of the control group at 1 d after operation(P<0.05,P<0.01).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion PVP is effective in the treatment of osteoporotic gradeⅠthoracolumbar compression fracture.It can effectively shorten the duration of operation,promote the postoperative recovery,improve the function of vertebral body,and rapidly relieve the pain of patients in the early stage,with certain safety.