早期经皮椎体成形术治疗骨质疏松性椎体压缩骨折的临床效果

Clinical effect of early percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures

目的探讨早期经皮椎体成形术治疗症状性胸腰椎骨质疏松性椎体压缩骨折(OVCF)的临床效果。方法将100例症状性胸腰椎OVCF患者分为早期组(采用早期经皮椎体成形术)与延迟组(采用延迟经皮椎体成形术),各50例。比较两组患者围术期相关指标、椎影像学结果、疼痛情况[视觉模拟评分法(VAS)评分]及腰椎功能[Oswestry功能障碍指数(ODI)评分]及预后情况。结果两组患者手术时间、术后下床时间、骨水泥注入量比较,差异均无统计学意义(P>0.05)。术后1周,两组患者的椎体前壁高度压缩率、椎体中线高度压缩率及Cobb角均小于术前,且早期组小于延迟组(P<0.01)。术后1周,两组患者VAS评分、ODI评分均低于术前,且早期组低于延迟组(P<0.01)。早期组患者相邻椎体畸形、伤椎再骨折发生率均低于延迟组(P<0.05或0.01)。结论与延迟经皮椎体成形术相比,症状性胸腰椎OVCF患者采用早期经皮椎体成形术治疗,可更好地促进伤椎生理结构和功能的恢复,并能减轻疼痛、改善预后。

Objective To explore the clinical effect of early percutaneous vertebroplasty in the treatment of symptomatic thoracolumbar osteoporotic vertebral compression fractures(OVCF).Methods A total of 100 patients with symptomatic thoracolumbar OVCF were divided into E group(undergoing early percutaneous vertebroplasty)and D group(doing delayed percutaneous vertebroplasty),with 50 ones in each.Perioperative relevant indexes,ver tebral imaging results,pain condition(Visual Analogue Scale[VAS]score),lumber vertebral function(Oswestry Disability Index[ODI]),and prognosis were compared between two groups.Results Intergoup differences in operation time,postoperative out-ofbed time,and injection amount of bone cement weren't statistically significant(P>0.05).Anterior and midline vertebral body height compression ratio as well as Cobb angle in both groups were less in 1week after operation compared with pre-operation and so were those in E than D group(P<0.01).Scores on the VAS and ODI in both groups were lower in 1 week after operation compared with pre-operation and so were those in E than D group(P<0.01).The incidences of adjacent vertebral deformities and refractures of injured vertebra were lower in E than D group(P<0.05 or 0.01).Conclusion Compared with delayed percutaneous vertebroplasty,early percutaneous vertebroplasty in the treatment of symptomatic thoracolumbar OVCF patients can better promote the recovery of physiological structure and function of injured vertebra,alleviate pain,and improve prognosis.