骨质疏松椎体压缩性骨折行椎体后凸成形术的不同手术时机对临床疗效的影响

Effect of Different Operation Time on Clinical Effect of Kyphoplasty for OsteoporoticVertebral Compression Fracture

探讨经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折患者的临床资料,探讨不同手术时机对临床疗效的影响。方法:回顾性收集并分析我院2018年1月-2019年12月采用经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折患者100例的临床资料,根据手术时机不同,将所有患者分为3组,A组患者病程在3天内;B组患者病程3-7天;C组患者病程7天以上。记录患者的一般资料及影像学数据。比较3组患者手术时间、椎体前缘高度压缩率、局部后凸角、术前与术后随访期间疼痛VAS评分、ODI指数。结果:成功纳入100例患者并均获得随访,随访时间平均3个月,随访期间未出现神经损伤、感染、骨水泥移位等并发症;与术前相比,术后3天、1个月、3个月疼痛VAS评分、ODI评分均明显降低,差异有统计学意义(P<0.05),且C组患者的术后VAS评分、ODI评分高于其他2组;椎体前缘高度及局部后凸角均有显著改善;3组数据比较,术后3个月C组患者的椎体前缘高度压缩率、局部后凸角大于其他2组。结论:不同的手术时机对经皮椎体后凸成形术治疗骨质疏松椎体压缩性骨折的临床疗效有一定的影响,病程越短,手术时间越早,临床效果越好,椎体高度恢复的程度越好。

To investigate the clinical data of percutaneous kyphoplasty(PVP)for the treatment of os-teoporotic vertebral compression fractures and the effect of different operation time on the clinical effect.Methods:The data of patients with osteoporotic vertebral compression fractures treated by percutaneous kyphoplasty from Janu-ary 2018 to December 2019 were retrospectively collected and analyzed.According to the timing of surgery,all pa-tients were divided into three groups.The course of patients in group A was within three days;The course of disease in group B was 3-7 days;The course of disease in group C was more than 7 days.The general information and ima-ging data of the patients were recorded.The operation time,the compression ratio of the leading edge of the vertebral body,the local posterior convex angle,the pain VAS score and ODI index were compared between the two groups.Results:100 patients were successfully included and all were followed up.The average follow-up time was 3 months.During the follow-up period,there were no complications such as nerve injury,infection and bone cement displacement.Compared with that before operation,the VAS score and ODI score of pain were significantly decreased at 3 days,1 month and 3 months after operation(P<0.05),and the height of vertebral body leading edge and lo-cal posterior convex angle were significantly improved.Compared with the data of the three groups,the VAS score and ODI score of the patients in group C were higher than those of the other two groups.The compression rate of the leading edge of the vertebral body and the local kyphosis angle of the patients in group C were higher than those of the other two groups at 3 months after operation.Conclusion:different operation timing has certain influence on the clin-ical effect of percutaneous kyphoplasty for the treatment of osteoporotic vertebral compression fractures.The shorter the course of disease,the earlier the operation time,the better the clinical effect and the better the recovery of verte-bral body height.