PVP与PKP治疗多节段老年骨质疏松性脊柱压缩骨折的效果

Effect of PVP and PKP in Treatment of Multisegment Osteoporotic Spinal Compression Fracture in Elderly

目的:探究经皮椎体成形术(PVP)与经皮椎体后凸成形术(PKP)治疗多节段老年骨质疏松性脊柱压缩骨折的效果。方法:回顾性分析黄石市第五医院2018年1月—2019年12月收治的92例多节段老年骨质疏松性脊柱压缩骨折患者资料,按照治疗方法分为两组,PVP组(n=46)采用PVP治疗,PKP组(n=46)采用PKP治疗。比较两组治疗效果、骨密度、疼痛功能[视觉模拟评分法(VAS)评分]、脊柱功能[Oswestry功能障碍指数(ODI)评分]及椎体情况。结果:PKP组治疗后总有效率为97.83%,高于PVP组的84.78%,差异有统计学意义(P<0.05)。术后6个月,PVP组和PKP组股骨头、下腰椎骨密度均较同组术前升高,且PKP组高于PVP组,差异有统计学意义(P<0.05)。术后6个月,PVP组和PKP组VAS、ODI评分均较同组术前降低,且术后PKP组低于PVP组,差异有统计学意义(P<0.05)。术后6个月,PVP组和PKP组椎体前缘高度、椎体后缘高度均明显升高、后突Cobb角均明显降低,且PKP组优于PVP组,差异有统计学意义(P<0.05)。结论:PVP与PKP治疗多节段老年骨质疏松性脊柱压缩骨折均具有明显效果,但PKP可缓解疼痛,促进椎体康复,提高脊柱功能,应用价值高。

Objective:To investigate the effect of percutaneous vertebroplasty(PVP)and percutaneous kyphoplasty(PKP)in the treatment of multisegment osteoporotic spinal compression fracture in the elderly.Method:Retrospective analysis was made on 92 cases of multisegment elderly osteoporotic spinal compression fracture admitted to the Fifth Hospital of Huangshi City from January 2018 to December 2019,and they were divided into two groups according to the treatment methods.PVP group(n=46)was treated with PVP surgery and PKP group(n=46)was treated with PKP surgery.The therapeutic effect,bone mineral density,pain function[visual analogue scale score(VAS)score],spinal function[Oswestry dysfunction index score(ODI score)]and vertebral body condition were compared between the two groups.Result:The total effective rate after treatment was 97.83%in PKP group,which was higher than 84.78%in PVP group,the difference was statistically significant(P<0.05).Six months after operation,the bone mineral density of femoral head and lower lumbar vertebrae in PVP group and PKP group were higher than those before operation,and the indexes in PKP group was higher than those in PVP group,the differences were statistically significant(P<0.05).Six months after operation,the VAS and ODI score in PVP group and PKP group were lower than those before operation,and the scores in PKP group were lower than those in PVP group,the differences were statistically significant(P<0.05).Six months after operation,the height of the anterior and posterior edge of the vertebral body in PVP group and PKP group increased significantly,and the Cobb angle of the posterior process decreased significantly than those before operation,the indexes in PKP group were significantly better than those in PVP group,the differences were statistically significant(P<0.05).Conclusion:PVP and PKP have obvious effects in the treatment of multisegment osteoporotic spinal compression fracture in the elderly,but PKP can relieve pain,promote vertebral rehabilitation,improve spinal function,and has high application value.