椎体成形术治疗老年骨质疏松性椎体压缩性骨折的临床疗效

Clinical efficacy of vertebroplasty in older adults with osteoporotic vertebral compression fracture

目的探讨椎体成形术治疗老年骨质疏松性椎体压缩性骨折(OVCF)的临床疗效。方法选取2012年1月至2019年5月本科采用经皮椎体成形术(PVP)及经皮椎体后凸成形术(PKP)治疗的38例老年OVCF患者作为研究对象,回顾性分析OVCF术后预后的相关因素。结果10例患者、14节椎体行PVP,28例患者、34节椎体行PKP。术后1个月,视觉模拟评分法(VAS)评分有效34例(89.5%),Oswestry功能障碍指数问卷表(ODI)评分良好35例(92.1%)。VAS评分有效和无效患者性别、手术方式、骨水泥渗透比较差异无统计学意义;VAS评分有效组和无效组患者年龄、邻近椎体骨折、术后并发症发生率比较差异有统计学意义(P<0.05)。ODI评分良好与不良患者性别、年龄、手术方式、骨水泥渗透比较差异无统计学意义;ODI评分良好与不良患者邻近椎体骨折、术后并发症发生率比较差异有统计学意义(P<0.05)。结论根据病情特点,选择适宜的椎体成形术进行个体化治疗,注意高龄患者围手术期基础疾病的治疗,缩短手术时间,注意术后并发症的防治,可改善老年OVCF患者预后。

Objective To explore the clinical efficacy of vertebroplasty in older adults with osteoporotic vertebral compression fracture(OVCF).Methods 38 elderly patients with OVCF who underwent percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in our department from January 2012 to May 2019 were selected as the research subjects,the related factors of prognosis after OVCF were retrospectively analyzed.Results PVP was performed in 10 patients and 14 vertebral bodies,and PKP was performed in 28 patients and 34 vertebral bodies.1 month after operation,visual analogue score(VAS)score was effective in 34 cases(89.5%),and Oswestry dability index(ODI)score was good in 35 cases(92.1%).There was no significant difference in the gender,surgical method and bone cement penetration between the effective and ineffective VAS scores;there were significant differences in the age,incidences of adjacent vertebral fracture and postoperative complications rate between the effective and ineffective VAS score(P<0.05).There were no significant differences in the gender,age,surgical method and bone cement penetration between patients with good and bad ODI scores;there were significant differences in the incidences of adjacent vertebral fractures and postoperative complications rate between patients with good and bad ODI scores(P<0.05).Conclusion According to the characteristics of the disease,choosing the appropriate vertebroplasty for individualized treatment,paying attention to the treatment of the underlying diseases in the perioperative period of the elderly patients,shortening the operation time,and paying attention to the prevention and treatment of postoperative complications can improve the prognosis of elderly patients with OVCF.