经皮穿刺椎体球囊扩张成形术(PKP)治疗高龄骨质疏松性胸腰段压缩骨折的疗效分析

Efficacy Analysis of Percutaneous Vertebroplasty(PKP)in the Treatment of Elderly Osteoporotic Thoracolumbar Compression Fractures

目的探讨对骨质疏松性胸腰段压缩骨折患者采用经皮穿刺椎体成形术完成治疗后获得临床效果。方法方便选取2016年1月—2019年5月该院收治的380例骨质疏松性胸腰段压缩骨折患者进行治疗研究;随机分为常规组(采用传统手术方法进行治疗)和研究组(采用经皮穿刺椎体成形术进行治疗)各190例;比较两组患者椎体前缘高度、疼痛VAS评分、Cobb角、术中出血量、手术时间、临近椎体骨折发生率、骨水泥渗漏发生率以及脑脊液漏发生率。结果治疗前,研究组椎体前缘高度(0.57±0.17)cm、疼痛VAS评分(7.23±1.25)分、Cobb角(28.61±3.73)°同常规组椎体前缘高度(0.57±0.19)cm、疼痛VAS评分(7.18±1.22)分、Cobb角(28.63±3.82)°比较,差异无统计学意义(P>0.05);治疗后,研究组椎体前缘高度(0.87±0.26)cm高于常规组椎体前缘高度(0.71±0.22)cm,疼痛VAS评分(1.91±0.52)分、Cobb角(15.49±1.63)°均低于常规组疼痛VAS评分(2.67±0.85)分、Cobb角(18.85±1.89)°,差异有统计学意义(t=6.475、10.513、18.556,P<0.05)。研究组术中出血量(55.43±7.63)mL少于常规组术中出血量(143.21±20.39)mL,手术时间(52.41±2.59)min短于常规组手术时间(70.05±11.29)min,差异有统计学意义(P<0.05)。研究组临近椎体骨折发生率(0.53%)、骨水泥渗漏发生率(0.00%)以及脑脊液漏发生率(0.53%)同常规组临近椎体骨折发生率(0.00%)、骨水泥渗漏发生率(0.53%)以及脑脊液漏发生率(0.00%)比较,差异无统计学意义(P>0.05)。结论经皮穿刺椎体成形术有效应用后,同传统手术方法比较,可提高患者椎体前缘高度,缓解疼痛程度,减小Cobb角,减少术中出血量,缩短手术时间。并且不会导致临近椎体骨折发生率、骨水泥渗漏发生率以及脑脊液漏发生率增加,可促进骨质疏松性胸腰段压缩骨折患者总体预后水平提升。

Objective To investigate the clinical effect of percutaneous vertebroplasty in patients with osteoporotic thoracolumbar compression fractures.Methods A total of 380 patients with osteoporotic thoracolumbar compression fractures admitted from January 2016 to May 2019 were conveniently selected for treatment research.They were randomly divided into a routine group(treated by traditional surgical methods)and a study group(treated by percutaneous vertebroplasty),with 190 cases in each.The anterior vertebral height,pain VAS score,Cobb angle,intraoperative blood loss,operation time,incidence of adjacent vertebral fractures,bone cement leakage and cerebrospinal fluid leakage were compared between the two groups.Results Before treatment,the anterior height of vertebral body in the study group was(0.57±0.17)cm,the pain VAS score was(7.23±1.25)points,and the Cobb angle was(28.61±3.73)°.Compared with the conventional group,the height of the anterior edge of the vertebral body was(0.57±0.19)cm,the pain VAS score was(7.18±1.22)points,and the Cobb angle was(28.63±3.82)°,the difference was not statistically significant(P>0.05);after treatment,the height of the anterior edge of the vertebral body in the study group was(0.87±0.26)cm higher than that in the conventional group(0.71±0.22)cm,the pain VAS score was(1.91±0.52)points,and the Cobb angle was(15.49±1.63)°were lower than the conventional group pain VAS score(2.67±0.85)points,Cobb angle(18.85±1.89)°,the difference was statistically significant(t=6.475,10.513,18.556,P<0.05).The intraoperative blood loss in the study group was(55.43±7.63)mL less than that in the routine group(143.21±20.39)mL,and the operation time was(52.41±2.59)min shorter than the routine group(70.05±11.29)min,the difference was statistically significant(P<0.05).The incidence of adjacent vertebral fractures(0.53%),the incidence of bone cement leakage(0.00%),and the incidence of cerebrospinal fluid leakage(0.53%)in the study group,compared with the conventional group,the incidence of adjacent vertebral body fracture(0.00%),the incidence of bone cement leakage(0.53%)and the incidence of cerebrospinal fluid leakage(0.00%),the difference was not statistically significant(P>0.05).Conclusion After the effective application of percutaneous vertebroplasty,compared with the traditional surgical method,the height of the anterior edge of the vertebral body can be increased,the pain level can be relieved,the Cobb angle can be reduced,the intraoperative blood loss can be reduced,and the operation time can be shortened..It will not lead to an increase in the incidence of adjacent vertebral body fractures,bone cement leakage,and cerebrospinal fluid leakage,and can improve the overall prognosis of patients with osteoporotic thoracolumbar compression fractures.